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验证 STOP-Bang 问卷作为心血管危险因素患者阻塞性睡眠呼吸暂停筛查工具的有效性:系统评价和荟萃分析。

Validation of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnoea in patients with cardiovascular risk factors: a systematic review and meta-analysis.

机构信息

Faculty of Medicine, Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.

Faculty of Medicine, Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

BMJ Open Respir Res. 2021 Mar;8(1). doi: 10.1136/bmjresp-2020-000848.

Abstract

INTRODUCTION

Obstructive sleep apnoea (OSA) is highly prevalent in patients with cardiovascular risk factors and is associated with increased morbidity and mortality. This review presents the predictive parameters of the STOP-Bang questionnaire as a screening tool for OSA in this population.

METHODS

A search of databases was performed. The inclusion criteria were: (1) use of the STOP-Bang questionnaire to screen for OSA in adults (>18 years) with cardiovascular risk factors; (2) polysomnography or home sleep apnoea testing performed as a reference standard; (3) OSA defined by either Apnoea-Hypopnoea Index (AHI) or Respiratory Disturbance Index; and (4) data on predictive parameters of the STOP-Bang questionnaire. A random-effects model was used to obtain pooled predictive parameters of the STOP-Bang questionnaire.

RESULTS

The literature search resulted in 3888 articles, of which 9 papers met the inclusion criteria, involving 1894 patients. The average age of the included patients was 58±13 years with body mass index (BMI) of 30±6 kg/m, and 64% were male. The STOP-Bang questionnaire has a sensitivity of 89.1%, 90.7% and 93.9% to screen for all (AHI ≥5), moderate-to-severe (AHI ≥15) and severe (AHI≥30) OSA, respectively. The specificity was 32.3%, 22.5% and 18.3% and the area under the curve (AUC) was 0.86, 0.65 and 0.52 for all, moderate-to-severe and severe OSA, respectively.

CONCLUSION

The STOP-Bang questionnaire is an effective tool to screen for OSA (AHI≥5) with AUC of 0.86 in patients with cardiovascular risk factors.

摘要

简介

阻塞性睡眠呼吸暂停(OSA)在心血管危险因素患者中高发,并与发病率和死亡率增加相关。本综述介绍了 STOP-Bang 问卷作为此类人群中 OSA 筛查工具的预测参数。

方法

对数据库进行了检索。纳入标准为:(1)使用 STOP-Bang 问卷筛查心血管危险因素成人(>18 岁)的 OSA;(2)多导睡眠图或家庭睡眠呼吸暂停测试作为参考标准;(3)OSA 通过呼吸暂停低通气指数(AHI)或呼吸紊乱指数定义;(4)STOP-Bang 问卷预测参数的数据。使用随机效应模型获得 STOP-Bang 问卷的汇总预测参数。

结果

文献检索得到 3888 篇文章,其中 9 篇符合纳入标准,共纳入 1894 例患者。纳入患者的平均年龄为 58±13 岁,体重指数(BMI)为 30±6kg/m,64%为男性。STOP-Bang 问卷对所有(AHI≥5)、中重度(AHI≥15)和重度(AHI≥30)OSA 的筛查敏感度分别为 89.1%、90.7%和 93.9%。特异度分别为 32.3%、22.5%和 18.3%,曲线下面积(AUC)分别为 0.86、0.65 和 0.52。

结论

STOP-Bang 问卷是一种有效的筛查工具,用于筛查心血管危险因素患者的 OSA(AHI≥5),AUC 为 0.86。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d354/7934717/23d636cae2ca/bmjresp-2020-000848f01.jpg

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