Department of Digestive Surgery, Hospital Universitario Doctor Peset, Avenida Gaspar Aguilar 90, 46017, Valencia, Spain.
Department of Otolaryngology, Hospital Universitario Doctor Peset, 46017, Valencia, Spain.
Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3533-3539. doi: 10.1007/s00405-021-06660-5. Epub 2021 Feb 10.
Screening for obstructive sleep apnea (OSA) is recommended in patients scheduled for bariatric surgery because continuous positive airway pressure (CPAP) therapy in patients with moderate-to-severe OSA reduces postoperative complications. However, cardiorespiratory polygraphy (CRP) and polysomnography (PSG) are expensive and time-consuming. The present study aimed to assess whether at-home continuous overnight pulse oximetry can be used to diagnose moderate-to-severe OSA in patients scheduled for bariatric surgery.
In this prospective observational study, we enrolled consecutive patients scheduled for bariatric surgery. Patients with no prior OSA diagnosis were evaluated using the ESS, SBQ, and preoperative at-home CRP. Correlations were calculated between AHI and oximetry parameters. For each oximetry parameter, a receiver-operating characteristic (ROC) curve was generated to identify optimal cut-off values for diagnosing moderate-to-severe OSA.
In total, 117 patients were included. The oxygen desaturation index was the most correlated oximetry parameter; the optimal cut-off value for diagnosing moderate-to-severe OSA was 23.9. The sensitivity and specificity were 80 and 92%, respectively. The area under the ROC curve was 0.935.
At-home continuous overnight pulse oximetry could be used to screen moderate-to-severe OSA in patients scheduled for bariatric surgery because it would allow clinicians to implement early CPAP therapy and avoid preoperative PSG or CRP.
建议对接受减重手术的患者进行阻塞性睡眠呼吸暂停（OSA）筛查，因为中重度 OSA 患者的持续气道正压通气（CPAP）治疗可降低术后并发症。然而，心肺多导睡眠图（CRP）和多导睡眠图（PSG）既昂贵又耗时。本研究旨在评估在家中进行连续整夜脉搏血氧饱和度监测是否可用于诊断拟行减重手术的患者中至重度 OSA。
这是一项前瞻性观察性研究，我们纳入了连续拟行减重手术的患者。未诊断过 OSA 的患者使用 ESS、SBQ 和术前在家 CRP 进行评估。计算 AHI 与血氧仪参数之间的相关性。为每个血氧仪参数生成受试者工作特征（ROC）曲线，以确定诊断中至重度 OSA 的最佳截断值。
共纳入 117 例患者。氧减指数是最相关的血氧仪参数；诊断中至重度 OSA 的最佳截断值为 23.9。敏感性和特异性分别为 80%和 92%。ROC 曲线下面积为 0.935。
在家中进行连续整夜脉搏血氧饱和度监测可用于筛查拟行减重手术的患者中至重度 OSA，因为这可使临床医生实施早期 CPAP 治疗并避免术前 PSG 或 CRP。
