Kum Rauf Oğuzhan, Kundi Fatma Cemre Sazak, Baklacı Deniz, Kum Nurcan Yurtsever, Güler İsmail, Yılmaz Yavuz Fuat, Özcan Müge
Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of Otorhinolaryngology, Kahramankazan State Hospital, Ankara, Turkey.
Turk Arch Otorhinolaryngol. 2018 Sep;56(3):149-154. doi: 10.5152/tao.2018.2928. Epub 2018 Sep 1.
An adequate evaluation combined with an easily accessible test would be a useful way to direct the appropriate patients to sleep centers in circumstances with a limited opportunity for polysomnography (PSG). For this reason, it is necessary to use a screening method prior to PSG evaluation. The aim of the present study was to investigate whether the use of body mass index (BMI) and pulse oximetry is sufficient to predict the severity of obstructive sleep apnea syndrome (OSAS) without PSG.
A total of 956 patients who were admitted to a tertiary referral center with complaints of witnessed apnea, excessive daytime sleepiness, and previously performed PSG were included in the study. Data of PSG (included pulse oximetry) and BMI were investigated for the determination of cut-off points for parameters in the patients.
Based on the presence of severe OSAS, the cut-off points were ≥31.7 kg/m for BMI, <81% for minimum oxygen saturation (Min O), and ≥14.1 min for sleep time with oxygen saturation <90% (ST). Severe OSAS risk was found to be higher in patients with BMI ≥31.7 kg/m, ST ≥14.1 min, and Min O ≤81% than in those without (OR: 37.173; 95% CI: 22.465-61.510, p=0.001). Specificity and accuracy were 94.85% and 72.49%, respectively, when all three cut-off scores were provided.
The appropriate cut-off values obtained from combining BMI and pulse oximetry data can provide accurate results for predicting the severity of OSAS.
在多导睡眠图（PSG）检查机会有限的情况下，进行充分评估并结合易于获得的检测方法，将是引导合适患者前往睡眠中心的有效途径。因此，在PSG评估之前有必要采用一种筛查方法。本研究的目的是调查使用体重指数（BMI）和脉搏血氧饱和度测定法是否足以在不进行PSG检查的情况下预测阻塞性睡眠呼吸暂停低通气综合征（OSAS）的严重程度。
本研究纳入了956例因有目击性呼吸暂停、日间过度嗜睡症状并曾接受过PSG检查而入住三级转诊中心的患者。对PSG数据（包括脉搏血氧饱和度测定）和BMI进行调查，以确定患者各项参数的截断点。
基于重度OSAS的存在情况，BMI的截断点为≥31.7kg/m²，最低血氧饱和度（Min O）的截断点为<81%，血氧饱和度<90%的睡眠时间（ST）的截断点为≥14.1分钟。发现BMI≥31.7kg/m²、ST≥14.1分钟且Min O≤81%的患者发生重度OSAS的风险高于未出现上述情况的患者（比值比：37.173；95%置信区间：22.465 - 61.510，p = 0.001）。当提供所有三个截断分数时，特异性和准确性分别为94.85%和72.49%。
结合BMI和脉搏血氧饱和度测定数据获得的合适截断值可为预测OSAS的严重程度提供准确结果。
