Carlos Alberto Nigro1,2, Gonzalo Castaño3,4, Ignacio Bledel3,5, Alfredo Colombi6, María Cecilia Zicari6. 1. Head of Pneumonology, Hospital Alemán, Pueyrredón 1640, CP 1418, Ciudad Autónoma de Buenos Aires, Argentina. cnigro@intramed.net. 2. Staff of Pneumonology, Hospital Alemán, Pueyrredón 1640, 1418, Ciudad Autónoma de Buenos Aires, Argentina. cnigro@intramed.net. 3. Head of Pneumonology, Hospital Alemán, Pueyrredón 1640, CP 1418, Ciudad Autónoma de Buenos Aires, Argentina. 4. Staff of Pneumonology, Hospital Alemán, Pueyrredón 1640, 1418, Ciudad Autónoma de Buenos Aires, Argentina. 5. Staff of Pneumonology, Hospital Alemán, Pueyrredón 1640, 1418, Buenos Aires, Argentina. 6. Akonic SA, Av. Gral. Mosconi 2886, 1419, Buenos Aires, Argentina.
Abstract
OBJECTIVE: The objective of the study was to develop a multiparametric oximetry indicator (IMp-SpO2) to diagnose obstructive sleep apnea in adults. MATERIAL AND METHOD: 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. RESULTS: Of 1141 adults included in the study, experimental (571) and validation group (570) were similar (women 47% vs 45%, BMI 27.5 kg/m2 vs 27.2 kg/m2, 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). CONCLUSION: The IMp-SpO2 showed a > 90% accuracy for OSA diagnosis in adults.
OBJECTIVE: The objective of the study was to develop a multiparametric oximetry indicator (IMp-SpO2) to diagnose obstructive sleep apnea in adults. MATERIAL AND METHOD: 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. RESULTS: Of 1141 adults included in the study, experimental (571) and validation group (570) were similar (women 47% vs 45%, BMI 27.5 kg/m2 vs 27.2 kg/m2, 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). CONCLUSION: The IMp-SpO2 showed a > 90% accuracy for OSA diagnosis in adults.