E Deflandre1,2,3, S Degey4, J-F Brichant5, A-F Donneau6, R Frognier7, R Poirrier8, V Bonhomme9. 1. Department of Anesthesia, Clinique Saint-Luc of Bouge, Namur, Belgium. eric.deflandre@gmail.com. 2. Cabinet Medical ASTES, Jambes, Belgium. eric.deflandre@gmail.com. 3. University of Liege, Chaussee de Tongres, 29, 4000, Liege, Belgium. eric.deflandre@gmail.com. 4. Cabinet Medical ASTES, Jambes, Belgium. 5. Department of Anesthesia, University Hospital of Liege, University of Liege, Liege, Belgium. 6. Department of Health Science, University of Liege, Liege, Belgium. 7. Department of Pneumology, Clinique Saint-Luc of Bouge, Namur, Belgium. 8. Department of Neurology, University of Liege, Liege, Belgium. 9. University Department of Anesthesia and ICM, CHR Citadelle and CHU, Liege, Belgium.
Abstract
BACKGROUND: Severe obstructive sleep apnea (OSA) is an independent risk factor for perioperative complications. Clinical scores such as Snoring, Tiredness, Observed apnea, high blood Pressure, Body Mass Index (BMI) higher than 35 kg m-2, Age older than 50 years, Neck circumference larger than 40 cm, and male gender (STOP-Bang), perioperative sleep apnea prediction (P-SAP), and OSA50 have been proposed for detecting OSA. We recently proposed a new score based on morphological metrics only, the DES-OSA score. This study compared the DES-OSA score to the three other ones with regard to their ability to detect OSA. Obese patients are particularly at risk of OSA. METHODS: Following informed consent and institutional review board (IRB) approval, 1584 consecutive adults were. Should the STOP-Bang be indicative of increased risk of severe OSA, the patient was referred to complementary polysomnography (PSG). Eventual already existing recent PSG data were also collected. The abilities of the four scores to predict OSA severity were compared using sensitivity, specificity, Cohen's kappa coefficient (CKC), and area under ROC curve (AUROC) analysis. RESULTS: PSG was performed in 150 patients. For detecting severe OSA, OSA50 had the highest sensitivity [value (95 % CI) 0.98 (0.90-1)]. STOP-Bang was significantly less sensitive than P-SAP and OSA50. In that respect, DES-OSA was significantly more specific than the three other ones [0.75 (0.65-0.83)]. The AUROC of DES-OSA was significantly the largest [0.9 (0.84-0.95)]. The highest CKC at detecting severe OSA was 0.62 (0.49-0.74) for DES-OSA. Similar results were obtained for moderate to severe OSA prediction. CONCLUSIONS: DES-OSA, which is the only exclusively morphological score available, appears to surpass the three other scores in their ability to predict moderate to severe and severe OSA, at least in our setting and in our screened population. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov NCT02051829.
BACKGROUND: Severe obstructive sleep apnea (OSA) is an independent risk factor for perioperative complications. Clinical scores such as Snoring, Tiredness, Observed apnea, high blood Pressure, Body Mass Index (BMI) higher than 35 kg m-2, Age older than 50 years, Neck circumference larger than 40 cm, and male gender (STOP-Bang), perioperative sleep apnea prediction (P-SAP), and OSA50 have been proposed for detecting OSA. We recently proposed a new score based on morphological metrics only, the DES-OSA score. This study compared the DES-OSA score to the three other ones with regard to their ability to detect OSA. Obesepatients are particularly at risk of OSA. METHODS: Following informed consent and institutional review board (IRB) approval, 1584 consecutive adults were. Should the STOP-Bang be indicative of increased risk of severe OSA, the patient was referred to complementary polysomnography (PSG). Eventual already existing recent PSG data were also collected. The abilities of the four scores to predict OSA severity were compared using sensitivity, specificity, Cohen's kappa coefficient (CKC), and area under ROC curve (AUROC) analysis. RESULTS: PSG was performed in 150 patients. For detecting severe OSA, OSA50 had the highest sensitivity [value (95 % CI) 0.98 (0.90-1)]. STOP-Bang was significantly less sensitive than P-SAP and OSA50. In that respect, DES-OSA was significantly more specific than the three other ones [0.75 (0.65-0.83)]. The AUROC of DES-OSA was significantly the largest [0.9 (0.84-0.95)]. The highest CKC at detecting severe OSA was 0.62 (0.49-0.74) for DES-OSA. Similar results were obtained for moderate to severe OSA prediction. CONCLUSIONS:DES-OSA, which is the only exclusively morphological score available, appears to surpass the three other scores in their ability to predict moderate to severe and severe OSA, at least in our setting and in our screened population. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov NCT02051829.
Authors: Ching Li Chai-Coetzer; Nick A Antic; L Sharn Rowland; Peter G Catcheside; Adrian Esterman; Richard L Reed; Helena Williams; Sandra Dunn; R Doug McEvoy Journal: Thorax Date: 2011-01-20 Impact factor: 9.139
Authors: Flavia S Nunes; Naury J Danzi-Soares; Pedro R Genta; Luciano F Drager; Luiz A M Cesar; Geraldo Lorenzi-Filho Journal: Sleep Breath Date: 2014-03-26 Impact factor: 2.816
Authors: Eric Deflandre; Nicolas Piette; Vincent Bonhomme; Stephanie Degey; Laurent Cambron; Robert Poirrier; Jean-Francois Brichant; Jean Joris Journal: PLoS One Date: 2018-05-07 Impact factor: 3.240