A new tool to screen patients with severe obstructive sleep apnea in the primary care setting: a prospective multicenter study.
BMC Pulm Med
; 22(1): 38, 2022 Jan 15.
Article
en En
| MEDLINE
| ID: mdl-35033055
ABSTRACT
BACKGROUND:
The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting.METHODS:
Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the ß coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed.RESULTS:
194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763-0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863-0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7-92.1) and specificity of 67.8% (95% CI 55.1-78.3).CONCLUSIONS:
The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry ClinicalTrials.gov; Name PASHOS Project Advanced Platform for Sleep Apnea Syndrome Assessment; URL https//clinicaltrials.gov/ct2/show/NCT02591979 ; Identifier NCT02591979. Date of registration October 30, 2015.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Indicadores de Salud
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Técnicas y Procedimientos Diagnósticos
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Apnea Obstructiva del Sueño
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
/
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Límite:
Adolescent
/
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
BMC Pulm Med
Año:
2022
Tipo del documento:
Article
País de afiliación:
España