INTRODUCTION: Obesity-hypoventilation syndrome (OHS) is associated with significant morbidity and mortality and requires measurement of arterial pCO2 for diagnosis. OBJECTIVE: To determine diagnostic predictors of OHS among obese patients with suspected obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: Retrospective analysis of data on 525 sleep clinic patients (mean age 51.4 ± 12.7 years; 65.7% males; mean BMI 34.5 ± 8.1). All patients had sleep studies, and arterialized capillary blood gases (CBG) were measured in obese subjects (BMI > 30 kg/m2). RESULTS: Of 525 patients, 65.5% were obese, 37.2% were morbidly obese (BMI > 40 kg/m2); 52.3% had confirmed OSAHS. Hypercapnia (pCO2 > 6 kPa or 45 mm Hg) was present in 20.6% obese and 22.1% OSAHS patients. Analysis of OHS predictors showed significant correlations between pCO2 and BMI, FEV1, FVC, AHI, mean and minimum nocturnal SpO2, sleep time with SpO2 < 90%, pO2, and calculated HCO3 from the CBG. PO2 and HCO3 were independent predictors of OHS, explaining 27.7% of pCO2 variance (p < 0.0001). A calculated HCO3 cutoff > 27 mmol/L had 85.7% sensitivity and 89.5% specificity for diagnosis of OHS, with 68.1% positive and 95.9% negative predictive value. CONCLUSION: We confirmed a high prevalence of OHS in obese OSAHS patients (22.1%) and high calculated HCO3 level (> 27 mmol/L) to be a sensitive and specific predictor for the diagnosis of OHS.
INTRODUCTION:Obesity-hypoventilation syndrome (OHS) is associated with significant morbidity and mortality and requires measurement of arterial pCO2 for diagnosis. OBJECTIVE: To determine diagnostic predictors of OHS among obesepatients with suspected obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: Retrospective analysis of data on 525 sleep clinic patients (mean age 51.4 ± 12.7 years; 65.7% males; mean BMI 34.5 ± 8.1). All patients had sleep studies, and arterialized capillary blood gases (CBG) were measured in obese subjects (BMI > 30 kg/m2). RESULTS: Of 525 patients, 65.5% were obese, 37.2% were morbidly obese (BMI > 40 kg/m2); 52.3% had confirmed OSAHS. Hypercapnia (pCO2 > 6 kPa or 45 mm Hg) was present in 20.6% obese and 22.1% OSAHSpatients. Analysis of OHS predictors showed significant correlations between pCO2 and BMI, FEV1, FVC, AHI, mean and minimum nocturnal SpO2, sleep time with SpO2 < 90%, pO2, and calculated HCO3 from the CBG. PO2 and HCO3 were independent predictors of OHS, explaining 27.7% of pCO2 variance (p < 0.0001). A calculated HCO3 cutoff > 27 mmol/L had 85.7% sensitivity and 89.5% specificity for diagnosis of OHS, with 68.1% positive and 95.9% negative predictive value. CONCLUSION: We confirmed a high prevalence of OHS in obese OSAHSpatients (22.1%) and high calculated HCO3 level (> 27 mmol/L) to be a sensitive and specific predictor for the diagnosis of OHS.
Authors: Sogol Nowbar; Kristin M Burkart; Ralph Gonzales; Andrew Fedorowicz; Wendolyn S Gozansky; Jon C Gaudio; Matthew R G Taylor; Clifford W Zwillich Journal: Am J Med Date: 2004-01-01 Impact factor: 4.965
Authors: Michael V Braganza; Patrick J Hanly; Kristin L Fraser; Willis H Tsai; Sachin R Pendharkar Journal: J Clin Sleep Med Date: 2020-09-15 Impact factor: 4.062
Authors: Babak Mokhlesi; Juan Fernando Masa; Jan L Brozek; Indira Gurubhagavatula; Patrick B Murphy; Amanda J Piper; Aiman Tulaimat; Majid Afshar; Jay S Balachandran; Raed A Dweik; Ronald R Grunstein; Nicholas Hart; Roop Kaw; Geraldo Lorenzi-Filho; Sushmita Pamidi; Bhakti K Patel; Susheel P Patil; Jean Louis Pépin; Israa Soghier; Maximiliano Tamae Kakazu; Mihaela Teodorescu Journal: Am J Respir Crit Care Med Date: 2019-08-01 Impact factor: 21.405