识别睡眠呼吸暂停患者的DES-OSA评分:一个验证研究和改善建议
Reudor Grinberg1, Sivan Perl2, Itzhack Shpirer2
1Intensive Care Unit, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.
The Israel Medical Association journal : IMAJ
|June 29, 2023
概括
阻塞性睡眠呼吸暂停 (DES-OSA) 评分有效地识别了需要治疗阻塞性睡眠呼吸暂停综合征 (OSAS) 的患者. 将66岁以上的年龄添加到DES-OSA得分中,可以提高其诊断OSAS的能力.
科学领域:
- 睡眠医学 睡眠医学
- 诊断的准确性 诊断的准确性
- 临床评估 临床评估
背景情况:
- 阻塞性睡眠呼吸暂停综合征 (OSAS) 的诊断依赖于临床评估和多睡眠学.
- 阻塞性睡眠呼吸暂停 (DES-OSA) 评分利用形态特征来预测OSAS的存在和严重程度.
研究的目的:
- 在以色列人口中验证DES-OSA得分.
- 确定需要OSAS治疗的患者.
- 评估是否其他参数可以提高DES-OSA诊断价值.
主要方法:
- 在睡眠诊所对106名患者进行前性队列研究.
- 由两名医生进行的独立的多眠学审查.
- 计算DES-OSA得分,使用STOP和Epworth问卷,并提取心血管风险数据.
主要成果:
- DES-OSA得分与呼吸暂停-呼吸暂停指数 (AHI) 有正相关,并且在OSAS严重程度组之间有显著差异.
- 对于DES-OSA计算,观察者之间的高度一致性 (ICC 0.86).
- 对于中度至重度的OSAS,DES-OSA得分≤5显示出高灵敏度 (0.90) 和低特异性 (0.27);年龄>66提高了灵敏度.
结论:
- DES-OSA是基于体检的有效得分,用于排除需要治疗的OSAS.
- 一个DES-OSA得分≤5有效排除了中度至重度的OSAS.
- 将66岁以上的年龄纳入DES-OSA得分,提高了对OSAS的诊断灵敏度.
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