CTA is an excellent diagnostic tool in ED patients with low risk of ACS, with minimum time delay as compared to XECG, and also is safe for triaging such patients.
BackgroundPolysomnograms are not always feasible when sleep disordered breathing (SDB) is suspected in hospitalized patients. Portable monitoring is a practical alternative; however, it has not been recommended in patients with comorbidities.ObjectiveWe evaluated the accuracy of portable monitoring in hospitalized patients suspected of having SDB.DesignProspective observational study.SettingLarge, public, urban, teaching hospital in the United States.ParticipantsHospitalized patients suspected of having SDB.MethodsPatients underwent portable monitoring combined with actigraphy during the hospitalization and then polysomnography after discharge. We determined the accuracy of portable monitoring in predicting moderate to severe SDB and the agreement between the apnea hypopnea index measured by portable monitor (AHIPM) and by polysomnogram (AHIPSG).ResultsSeventy-one symptomatic patients completed both tests. The median time between the two tests was 97 days (IQR 25–75: 24–109). Forty-five percent were hospitalized for cardiovascular disease. Mean age was 52±10 years, 41% were women, and the majority had symptoms of SDB. Based on AHIPSG, SDB was moderate in 9 patients and severe in 39. The area under the receiver operator characteristics curve for AHIPM was 0.8, and increased to 0.86 in patients without central sleep apnea; it was 0.88 in the 31 patients with hypercapnia. For predicting moderate to severe SDB, an AHIPM of 14 had a sensitivity of 90%, and an AHIPM of 36 had a specificity of 87%. The mean±SD difference between AHIPM and AHIPSG was 2±29 event/hr.ConclusionIn hospitalized, symptomatic patients, portable monitoring is reasonably accurate in detecting moderate to severe SDB.
INTRODUCTION: BHDS is a rare pulmonary cystic disease associated with pulmonary cysts in 80-90% cases. It causes spontaneous pneumothorax in 35% cases and recurrence rate is 75%. It is an autosomal dominant genetic disorder, incidence is unknown and approximately 200 families have been identified worldwide.
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