A new tool to screen patients with severe obstructive sleep apnea in the primary care setting

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. Anthropometric data, clinical history, and symptoms of OSA were recorded...

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Detalles Bibliográficos
Autores: Peñacoba, Patricia|||0000-0001-8943-7425, Llauger, Maria Antònia, Fortuna Gutiérrez, Ana Mª|||0000-0002-3619-1609, Flor Escriche, Xavier|||0000-0002-0304-8224, Sampol, Gabriel|||0000-0003-0090-4758, Pedro-Pijoan, Anna Maria|||0000-0001-5348-6612, Grau, Núria, Santiveri, Carme, Juvanteny, Joan|||0000-0002-9856-4079, Aoiz, José Ignacio|||0000-0003-2173-3484, Bayó, Joan, Lloberes Canadell, Patricia|||0000-0002-1595-8225, Mayos, Merce|||0000-0003-3972-3671
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:251203
Acceso en línea:https://ddd.uab.cat/record/251203
https://dx.doi.org/urn:doi:10.1186/s12890-022-01827-0
Access Level:acceso abierto
Palabra clave:Obstructive sleep apnea
Continuous positive airway pressure (CPAP)
Primary healthcare
Sleep unit
Screening model
Home sleep apnea test
Descripción
Sumario: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. 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 β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed. 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). 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: ; Identifier: NCT02591979. Date of registration: October 30, 2015. The online version contains supplementary material available at 10.1186/s12890-022-01827-0.

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