BACKGROUND: Screening for obstructive sleep apnea (OSA) is recommended as part of the preoperative assessment of obese patients scheduled for bariatric surgery. The objective of this study was to compare the sensitivity of oximetry alone versus portable polygraphy in the preoperative screening for OSA. METHODS: Polygraphy (type III portable monitor) and oximetry data recorded as part of the preoperative assessment before bariatric surgery from 68 consecutive patients were reviewed. We compared the sensitivity of 3% or 4% desaturation index (oximetry alone) with the apnea-hypopnea index (AHI; polygraphy) to diagnose OSA and classify the patients as normal (<10 events per hour), mild to moderate (10-30 events per hour), or severe (>30 events per hour). RESULTS: Using AHI, the prevalence of OSA (AHI > 10 per hour) was 57.4%: 16.2% of the patients were classified as severe, 41.2% as mild to moderate, and 42.6% as normal. Using 3% desaturation index, 22.1% were classified as severe, 47.1% as mild to moderate, and 30.9% as normal. With 4% desaturation index, 17.6% were classified as severe, 32.4% as mild, and 50% as normal. Overall, 3% desaturation index compared to AHI yielded a 95% negative predictive value to rule out OSA (AHI > 10 per hour) and a 100% sensitivity (0.73 positive predictive value) to detect severe OSA (AHI > 30 per hour). CONCLUSIONS: Using oximetry with 3% desaturation index as a screening tool for OSA could allow us to rule out significant OSA in almost a third of the patients and to detect patients with severe OSA. This cheap and widely available technique could accelerate preoperative work-up of these patients.
BACKGROUND: Screening for obstructive sleep apnea (OSA) is recommended as part of the preoperative assessment of obesepatients scheduled for bariatric surgery. The objective of this study was to compare the sensitivity of oximetry alone versus portable polygraphy in the preoperative screening for OSA. METHODS: Polygraphy (type III portable monitor) and oximetry data recorded as part of the preoperative assessment before bariatric surgery from 68 consecutive patients were reviewed. We compared the sensitivity of 3% or 4% desaturation index (oximetry alone) with the apnea-hypopnea index (AHI; polygraphy) to diagnose OSA and classify the patients as normal (<10 events per hour), mild to moderate (10-30 events per hour), or severe (>30 events per hour). RESULTS: Using AHI, the prevalence of OSA (AHI > 10 per hour) was 57.4%: 16.2% of the patients were classified as severe, 41.2% as mild to moderate, and 42.6% as normal. Using 3% desaturation index, 22.1% were classified as severe, 47.1% as mild to moderate, and 30.9% as normal. With 4% desaturation index, 17.6% were classified as severe, 32.4% as mild, and 50% as normal. Overall, 3% desaturation index compared to AHI yielded a 95% negative predictive value to rule out OSA (AHI > 10 per hour) and a 100% sensitivity (0.73 positive predictive value) to detect severe OSA (AHI > 30 per hour). CONCLUSIONS: Using oximetry with 3% desaturation index as a screening tool for OSA could allow us to rule out significant OSA in almost a third of the patients and to detect patients with severe OSA. This cheap and widely available technique could accelerate preoperative work-up of these patients.
Authors: Martin Fried; Vojtech Hainer; Arnaud Basdevant; Henry Buchwald; Mervyn Deitel; Nicholas Finer; Jan Willem M Greve; Fritz Horber; Elisabeth Mathus-Vliegen; Nicola Scopinaro; Rudolf Steffen; Constantine Tsigos; Rudolf Weiner; Kurt Widhalm Journal: Obes Surg Date: 2007-02 Impact factor: 4.129
Authors: Roop Kaw; Loutfi Aboussouan; Dennis Auckley; Charles Bae; David Gugliotti; Paul Grant; Wael Jaber; Philip Schauer; Daniel Sessler Journal: Obes Surg Date: 2007-11-16 Impact factor: 4.129
Authors: R J Schwab; A I Pack; K B Gupta; L J Metzger; E Oh; J E Getsy; E A Hoffman; W B Gefter Journal: Am J Respir Crit Care Med Date: 1996-10 Impact factor: 21.405
Authors: Daniel Álvarez; Gonzalo C Gutiérrez-Tobal; Fernando Vaquerizo-Villar; Fernando Moreno; Félix Del Campo; Roberto Hornero Journal: Adv Exp Med Biol Date: 2022 Impact factor: 3.650
Authors: Arthur Dawson; Richard T Loving; Robert M Gordon; Susan L Abel; Derek Loewy; Daniel F Kripke; Lawrence E Kline Journal: BMJ Open Date: 2015-06-30 Impact factor: 2.692
Authors: Adelaide Withers; Jennifer Maul; Ellen Rosenheim; Anne O'Donnell; Andrew Wilson; Stephen Stick Journal: J Clin Sleep Med Date: 2022-02-01 Impact factor: 4.062