Pre-Operative Ability of Clinical Scores to Predict Obstructive Sleep Apnea (OSA) Severity in Susceptible Surgical Patients

Deflandre, Eric; Degey, Stéphanie; Brichant, Jean-François; Donneau, Anne‐Françoise; Frognier, R.; Poirrier, Robert; Bonhomme, Vincent

doi:10.1007/s11695-016-2352-4

Cited by 17 publications

(21 citation statements)

References 39 publications

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“…In the surgical population, two of six studies reported data at multiple cut-off points for the STOP-Bang questionnaire for moderate-to-severe OSA (AHI ≥ 15) [ 62 , 63 ]. Increasing the threshold from 4 to 7 increased specificity from 31% (95% CI: 0.2, 0.4) to 96% (95% CI: 0.89, 0.99) and was greatest at cut-off values ≥ 6 and ≥ 7 (Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of screening questionnaires for obstructive sleep apnoea in adults in different clinical cohorts: a systematic review and meta-analysis

et al. 2021

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Purpose The majority of individuals with clinically significant obstructive sleep apnoea (OSA) are undiagnosed and untreated. A simple screening tool may support risk stratification, identification, and appropriate management of at-risk patients. Therefore, this systematic review and meta-analysis evaluated and compared the accuracy and clinical utility of existing screening questionnaires for identifying OSA in different clinical cohorts. Methods We conducted a systematic review and meta-analysis of observational studies assessing the diagnostic value of OSA screening questionnaires. We identified prospective studies, validated against polysomnography, and published to December 2020 from online databases. To pool the results, we used random effects bivariate binomial meta-analysis. Results We included 38 studies across three clinical cohorts in the meta-analysis. In the sleep clinic cohort, the Berlin questionnaire’s pooled sensitivity for apnoea-hypopnoea index (AHI) ≥ 5, ≥ 15, and ≥ 30 was 85%, 84%, and 89%, and pooled specificity was 43%, 30%, and 33%, respectively. The STOP questionnaire’s pooled sensitivity for AHI ≥ 5, ≥ 15, and ≥ 30 was 90%, 90%, and 95%, and pooled specificity was 31%, 29%, and 21%. The pooled sensitivity of the STOP-Bang questionnaire for AHI ≥ 5, ≥ 15, and ≥ 30 was 92%, 95%, and 96%, and pooled specificity was 35%, 27%, and 28%. In the surgical cohort (AHI ≥ 15), the Berlin and STOP-Bang questionnaires’ pooled sensitivity were 76% and 90% and pooled specificity 47% and 27%. Conclusion Among the identified questionnaires, the STOP-Bang questionnaire had the highest sensitivity to detect OSA but lacked specificity. Subgroup analysis considering other at-risk populations was not possible. Our observations are limited by the low certainty level in available data. Supplementary Information The online version contains supplementary material available at 10.1007/s11325-021-02450-9.

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Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of screening questionnaires for obstructive sleep apnoea in adults in different clinical cohorts: a systematic review and meta-analysis

et al. 2021

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“…Рівень тривожності та депресії оцінювався вранці після першої після операційної ночі з використанням госпіталь-ної шкали тривоги та депресії (HADS) [14,15]. Ризик обструктивного сонного апное оцінювався за шкалою DES-OSA [16]. Також проводилась оцінка анестезіологічного ризику за ASA, тривалості оперативного втручання, очікуваного рівня болю та споживання ненаркотичних та наркотичних анальгетиків [17].…”

Section: матеріали та методиunclassified

Частота И Факторы Развития Послеоперационной Инсомнии

Boduliev¹,

Шкурупій²

2021

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Протягом останніх десятиріч у структурі надання медичної допомоги населенню постійно зростає питома вага оперативних втручань. Так, цей показник по Україні зріс із 523,18 на 10 тис. населення у 2003 році до 540,79 на 10 тис. населення у 2013 році [1]. Зі зростанням безпеки операцій все більшу роль відіграє забезпечення якості життя хворого, включаючи ранній післяопераційний період. Безперечно, поряд із болем порушення сну викликає найбільший дискомфорт протягом перших діб після оперативного втручання [2]. Проте порушення сну не тільки спричинюють дискомфорт, але й можуть формувати серйозні ускладнення та підвищувати ризик летальності [3]. Періопераційна інсомнія провокує розвиток делірію [4], гіпертензії [5], гіперглікемії [6], аритмій, зокрема фатальних [7], порушення загоєння операційної рани [8]. Недостатність сну має причинно-наслідковий зв'язок із сімома з п'ятнадцяти основних причин смерті, зокрема кардіо-та цереброваскулярними подіями, цукровим діабетом та гіпертонічною хворобою [9]. У загальній популяції інсомнія є одним із найчастіших розладів здоров'я.

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“…Several predictive scores have been proposed and validated to detect OSA patients preoperatively. The four scores most often used in anesthesia are the STOP-Bang, the P-SAP, the OSA50, and the DES-OSA scores [ 22 – 27 ]. These scores are illustrated in Fig 1 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical scores in their ability to detect hypoxemic severe OSA patients

et al. 2018

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BackgroundSevere obstructive sleep apnea (sOSA) and preoperative hypoxemia are risk factors of postoperative complications. Patients exhibiting the combination of both factors are probably at higher perioperative risk. Four scores (STOP-Bang, P-SAP, OSA50, and DES-OSA) are currently used to detect OSA patients preoperatively. This study compared their ability to specifically detect hypoxemic sOSA patients.MethodsOne hundred and fifty-nine patients scheduled for an overnight polysomnography (PSG) were prospectively enrolled. The ability of the four scores to predict the occurrence of hypoxemic episodes in sOSA patients was compared using sensitivity (Se), specificity (Sp), Youden Index, Cohen kappa coefficient, and the area under ROC curve (AUROC) analyses.ResultsOSA50 elicited the highest Se [95% CI] at detecting hypoxemic sOSA patients (1 [0.89–1]) and was significantly more sensitive than STOP-Bang in that respect. DES-OSA was significantly more specific (0.58 [0.49–0.66]) than the three other scores. The Youden Index of DES-OSA (1.45 [1.33–1.58]) was significantly higher than those of STOP-Bang, P-SAP, and OSA50. The AUROC of DES-OSA (0.8 [0.71–0.89]) was significantly the largest. The highest Kappa value was obtained for DES-OSA (0.33 [0.21–0.45]) and was significantly higher than those of STOP-Bang, and OSA50.ConclusionsIn our population, DES-OSA appears to be more effective than the three other scores to specifically detect hypoxemic sOSA patients. However prospective studies are needed to confirm these findings in a perioperative setting.Clinical trial registrationClinicalTrials.gov: NCT02050685.

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Pre-Operative Ability of Clinical Scores to Predict Obstructive Sleep Apnea (OSA) Severity in Susceptible Surgical Patients

Abstract: ClinicalTrial.gov NCT02051829.

Cited by 17 publications

References 39 publications

Diagnostic accuracy of screening questionnaires for obstructive sleep apnoea in adults in different clinical cohorts: a systematic review and meta-analysis

Diagnostic accuracy of screening questionnaires for obstructive sleep apnoea in adults in different clinical cohorts: a systematic review and meta-analysis

Частота И Факторы Развития Послеоперационной Инсомнии

Comparison of clinical scores in their ability to detect hypoxemic severe OSA patients

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