Head of Pneumonology, Hospital Alemán, Pueyrredón 1640, CP 1418, Ciudad Autónoma de Buenos Aires, Argentina.
Staff of Pneumonology, Hospital Alemán, Pueyrredón 1640, 1418, Ciudad Autónoma de Buenos Aires, Argentina.
Sleep Breath. 2022 Sep;26(3):1125-1134. doi: 10.1007/s11325-021-02439-4. Epub 2021 Sep 23.
The objective of the study was to develop a multiparametric oximetry indicator (IMp-SpO2) to diagnose obstructive sleep apnea in adults.
This was an observational, retrospective study of diagnostic accuracy. We included adults who had had a diagnostic polysomnography with few artifacts and a total sleep time of at least 180 min in the sleep laboratory. Obstructive sleep apnea (OSA) was defined as an apnea-hypopnea index (AHI) ≥ 5. The database was randomly divided into an experimental (Exp-G) and validation (Val-G) group. The program calculated several parameters of oxygen saturation variability (Par-VarSpO2): (a) oxygen desaturation index (ODI ≥ 3, 4%) and (b) 90, 95, and 97.5 percentiles of both the number of oxygen desaturations ≥ 3 and 4% (P90-97.5 OD3/4 W5-60) and SpO2 standard deviations in moving windows from 5 to 60 min (P90-P97.5 SDSpO2 W5-10). Area under the ROC curve (AUC-ROC), sensitivity, specificity, positive/negative likelihood ratios, and accuracy were calculated.
Of 1141 adults included in the study, experimental (571) and validation group (570) were similar (women 47% vs 45%, BMI 27.5 kg/m vs 27.2 kg/m, and AHI 11.7 vs 12, p NS). The IMp-SpO2 developed in the experimental group consisted of a combination of 10 parameters of oxygen saturation variability. The presence of at least one IMp-SpO2 variable had a high diagnostic performance for OSA (sensitivity/specificity/accuracy: Exp-G: 92.8/94/93.2%; Val-G: 93/95.2/93.7%). The IMp-SpO2 AUC-ROC was higher (Exp-G 0.934, Val-G 0.941) than most of the Par-VarSpO2 (0.898-0.929, p < 0.05).
The IMp-SpO2 showed a > 90% accuracy for OSA diagnosis in adults.
本研究旨在开发一种多参数血氧计指标（IMp-SpO2），以诊断成人阻塞性睡眠呼吸暂停。
这是一项观察性、回顾性诊断准确性研究。我们纳入了在睡眠实验室中进行过诊断性多导睡眠图检查且伪迹较少、总睡眠时间至少 180 分钟的成年人。阻塞性睡眠呼吸暂停（OSA）定义为呼吸暂停低通气指数（AHI）≥5。数据库被随机分为实验组（Exp-G）和验证组（Val-G）。该程序计算了几种血氧饱和度变异参数（Par-VarSpO2）：（a）氧减指数（ODI≥3、4%）和（b）氧减≥3 和 4%的第 90、95 和 97.5 百分位数（P90-97.5 OD3/4 W5-60）以及 SpO2 标准差在 5 到 60 分钟的移动窗口中（P90-P97.5 SDSpO2 W5-10）。计算了 ROC 曲线下面积（AUC-ROC）、敏感性、特异性、阳性/阴性似然比和准确性。
在纳入的 1141 名成年人中，实验组（571 人）和验证组（570 人）相似（女性占 47%比 45%，BMI 27.5kg/m 比 27.2kg/m，AHI 11.7 比 12，p NS）。在实验组中开发的 Imp-SpO2 由 10 个血氧饱和度变异参数的组合组成。至少存在一个 Imp-SpO2 变量对 OSA 具有较高的诊断性能（实验组：敏感性/特异性/准确性：92.8%/94%/93.2%；验证组：93%/95.2%/93.7%）。Imp-SpO2 AUC-ROC 高于大多数 Par-VarSpO2（0.898-0.929，p<0.05）。
Imp-SpO2 对成人 OSA 诊断的准确率>90%。
