STOP-Bang 问卷作为一种筛查工具在不同种族人群中用于阻塞性睡眠呼吸暂停的诊断性能。
Diagnostic performance of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnea in different ethnic groups.
机构信息
Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
出版信息
J Clin Sleep Med. 2021 Mar 1;17(3):521-532. doi: 10.5664/jcsm.8940.
STUDY OBJECTIVES
The STOP-Bang questionnaire is a concise and easy screening tool for obstructive sleep apnea (OSA). Using modified body mass index (BMI), we assessed the diagnostic performance of the STOP-Bang questionnaire in predicting OSA in ethnically different groups of patients undergoing surgery.
METHODS
This was a multicenter prospective cohort study involving patients with cardiovascular risk factors who were undergoing major noncardiac surgery. Patients underwent home sleep apnea testing. All patients completed the STOP-Bang questionnaire. The predictive parameters of STOP-Bang scores were calculated against the apnea-hypopnea index.
RESULTS
From 4 ethnic groups 1,205 patients (666 Chinese, 161 Indian, 195 Malay, and 183 Caucasian) were included in the study. The mean BMI ranged from 25 ± 4 to 30 ± 6 kg/m² and mean age ranged from 64 ± 8 to 71 ± 10 years. For the Chinese and Indian patients, diagnostic parameters are presented using BMI threshold of 27.5 kg/m² with the area under curve to predict moderate-to-severe OSA being 0.709 (0.665-0.753) and 0.722 (0.635-0.808), respectively. For the Malay and Caucasian, diagnostic parameters are presented using BMI threshold of 35 kg/m² with the area under curve for predicting moderate-to-severe OSA being 0.645 (0.572-0.720) and 0.657 (0.578-0.736), respectively. Balancing the sensitivity and specificity, the optimal STOP-Bang thresholds for the Chinese, Indian, Malay, and Caucasian groups were determined to be 4 or greater.
CONCLUSIONS
For predicting moderate-to-severe OSA, we recommend BMI threshold of 27.5 kg/m² for Chinese and Indian patients and 35 kg/m² for Malay and Caucasian patients. The optimal STOP-Bang threshold for the Chinese, Indian, Malay and Caucasian groups is 4 or greater.
CLINICAL TRIAL REGISTRATION
Registry: ClinicalTrials.gov; Name: Postoperative Vascular Events in Unrecognized Obstructive Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/study/NCT01494181; Identifier: NCT01494181.
研究目的
STOP-Bang 问卷是阻塞性睡眠呼吸暂停（OSA）的一种简洁易用的筛查工具。我们使用改良的体重指数（BMI）评估了 STOP-Bang 问卷在预测不同种族手术患者 OSA 中的诊断性能。
方法
这是一项多中心前瞻性队列研究，纳入了患有心血管危险因素并接受非心脏大手术的患者。患者进行了家庭睡眠呼吸暂停测试。所有患者均完成了 STOP-Bang 问卷。根据呼吸暂停低通气指数计算 STOP-Bang 评分的预测参数。
结果
从 4 个种族组共纳入 1205 名患者（666 名中国人、161 名印度人、195 名马来人和 183 名白种人）。BMI 均值范围为 25 ± 4 至 30 ± 6 kg/m²，年龄均值范围为 64 ± 8 至 71 ± 10 岁。对于中国人和印度人患者，使用 BMI 阈值 27.5 kg/m² 呈现诊断参数，预测中重度 OSA 的曲线下面积分别为 0.709（0.665-0.753）和 0.722（0.635-0.808）。对于马来人和白种人患者，使用 BMI 阈值 35 kg/m² 呈现诊断参数，预测中重度 OSA 的曲线下面积分别为 0.645（0.572-0.720）和 0.657（0.578-0.736）。平衡敏感性和特异性，确定中国人、印度人、马来人和白种人组的最佳 STOP-Bang 阈值为 4 或更高。
结论
对于预测中重度 OSA，我们建议中国人和印度患者使用 BMI 阈值 27.5 kg/m²，马来人和白种人患者使用 BMI 阈值 35 kg/m²。中国人、印度人、马来人和白种人组的最佳 STOP-Bang 阈值为 4 或更高。
临床实验注册
注册处：ClinicalTrials.gov；名称：未识别的阻塞性睡眠呼吸暂停术后血管事件；网址：https://clinicaltrials.gov/ct2/show/study/NCT01494181；标识符：NCT01494181。
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