Application of Neck Circumference in Four-Variable Screening Tool for Early Prediction of Obstructive Sleep Apnea in Acute Ischemic Stroke Patients.
J Stroke Cerebrovasc Dis
; 28(9): 2517-2524, 2019 Sep.
Article
em En
| MEDLINE
| ID: mdl-31296477
ABSTRACT
BACKGROUND:
The purpose of this study was to validate and pilot the use of the four-variable screening tool (4V) and modified 4V tools to identify acute ischemic stroke and transient ischemic attack (TIA) patients at high risk of obstructive sleep apnea (OSA).METHODS:
Two modified scales, 4V-1 (ie, using neck circumference instead body mass index, regardless of gender) and 4V-2 (ie, as above but scored differently according to gender) were designed. These tools were used in a consecutive cohort of 124 acute ischemic stroke/TIA patients, together with the 4V-1, 4V-2, 4V, as well as the STOP-BANG, the Berlin questionnaire, and the Epworth Sleepiness Scale (ESS). Objective level 2 or level 3 polysomnography was used to confirm OSA and its severity. Both questionnaires and polysomnography were completed within 1 week from symptom onset.RESULTS:
Area under the curve (AUC) of 4V was 0.807 (P< .0001) while AUC of STOP-BANG, Berlin Questionnaire and ESS were .701 (P< .0001), .704 (P< .0001) and .576 (Pâ¯=â¯.1556), respectively. AUC of 4V was greater than of STOP-BANG (zâ¯=â¯2.200, Pâ¯=â¯.0220), Berlin (zâ¯=â¯2.024, Pâ¯=â¯.0430) and ESS (zâ¯=â¯3.363, Pâ¯=â¯.0003). AUC of modified 4V-1 and modified 4V-2 were .824 (P< .001) and .835 (P< .001), respectively. Performance of modified 4V-2 was higher versus modified 4V-1 (zâ¯=â¯2.111, Pâ¯=â¯.0348) and higher but not significantly so to regular 4V (zâ¯=â¯1.784, Pâ¯=â¯.0744).CONCLUSIONS:
Neck circumference scored by gender is a useful substitution to body mass index in the 4V when screening OSA at early stages of ischemic stroke/TIA patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Ataque Isquêmico Transitório
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Técnicas de Apoio para a Decisão
/
Apneia Obstrutiva do Sono
/
Acidente Vascular Cerebral
/
Pescoço
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Assunto da revista:
ANGIOLOGIA
/
CEREBRO
Ano de publicação:
2019
Tipo de documento:
Article