STOP-Bang 量表、Epworth 嗜睡量表和颈围与身高比用于检测重度肥胖中重度阻塞性睡眠呼吸暂停低通气综合征的效用。

Utility of the STOP-Bang and Epworth scales and the neck-to-height ratio to detect severe obstructive apnea-hypopnea syndrome in severe obesity.

机构信息

Servicio de Endocrinología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.

Servicio de Medicina Interna, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.

出版信息

Surg Obes Relat Dis. 2021 Feb;17(2):257-262. doi: 10.1016/j.soard.2020.10.014. Epub 2020 Oct 16.

DOI:10.1016/j.soard.2020.10.014

PMID:33234465

Abstract

BACKGROUND

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is present in 80% of patients evaluated for bariatric surgery (BS). Extensive evaluation is not widely available, but treatment is mandatory for severe cases. The Snore, Tiredness, Observed apneas and Pressure - Body mass index, Age, Neck circumference and Gender (STOP-Bang) and Epworth questionnaires and neck-to-height ratio (NHtR) are accessible clinical tools to screen for sleep and metabolic disturbances, but their utility to detect severe OSAHS in patients with severe obesity has not been determined.

OBJECTIVES

To evaluate the cutoff point of those clinical tools that may predict severe OSAHS, confirmed by polysomnography in patients referred for BS.

SETTING

Tertiary referral center in Mexico City.

METHODS

We applied the STOP-Bang and Epworth questionnaires, evaluated anthropometric characteristics, and collected samples for arterial gasometry and metabolic parameters from 68 patients with severe obesity, who were then referred for polysomnography before their evaluation for BS.

RESULTS

Of the 68 patients participating in the study, 67.7% were female, with a median age of 43 years (35-49 years) and a body mass index (BMI) of 45.5 kg/m (42.4-50.9 kg/m; 28.3% had a BMI ≥ 50 kg/m). A STOP-Bang cutoff >5 points had a sensitivity of 60% and specificity of 90% for detecting severe OSAHS (area under the curve [AUC] = .962); meanwhile, an NHtR >.25 had a sensitivity of 90% and specificity of 52.5% (AUC = .759). The Epworth scale score >11 points had a sensitivity of 57.1% and specificity of 83.3% (AUC = .802).

CONCLUSION

Clinical data may be useful to detect severe sleep apnea in high-risk populations, allowing for rapid referral and better use of resources.

摘要

背景

阻塞性睡眠呼吸暂停低通气综合征（OSAHS）在接受减重手术（BS）评估的患者中占 80%。广泛的评估并不广泛，但对于严重病例，治疗是强制性的。打鼾、疲倦、观察到的呼吸暂停和压力-体重指数、年龄、颈围和性别（STOP-Bang）和 Epworth 问卷以及颈高比（NHtR）是可用于筛查睡眠和代谢紊乱的临床工具，但它们在检测严重肥胖患者中严重 OSAHS 的能力尚未确定。

目的

评估这些临床工具的截止值，这些工具可通过多导睡眠图（PSG）在接受 BS 评估的患者中预测严重 OSAHS。

设置

墨西哥城的三级转诊中心。

方法

我们对 68 例严重肥胖患者进行了 STOP-Bang 和 Epworth 问卷评估、人体测量特征评估，并采集了动脉血气和代谢参数样本，然后在对 BS 进行评估之前对其进行了 PSG 检查。

结果

在参与研究的 68 例患者中，67.7%为女性，中位年龄为 43 岁（35-49 岁），体重指数（BMI）为 45.5 kg/m（42.4-50.9 kg/m；28.3%的 BMI≥50 kg/m）。STOP-Bang 截断值>5 分对检测严重 OSAHS 的敏感性为 60%，特异性为 90%（曲线下面积[AUC]为.962）；同时，NHtR>0.25 的敏感性为 90%，特异性为 52.5%（AUC 为.759）。Epworth 量表评分>11 分对检测严重睡眠呼吸暂停的敏感性为 57.1%，特异性为 83.3%（AUC 为.802）。