Clinical Predictors of Obesity Hypoventilation Syndrome in Obese Subjects With Obstructive Sleep Apnea.
BACKGROUND: Arterial blood gas (ABG) analysis is not a routine test in sleep laboratories due to its invasive nature. Therefore, the diagnosis of obesity hypoventilation syndrome (OHS) is underestimated. We aimed to evaluate the differences in subjects with OHS and pure obstructive sleep apnea (OSA)...
| Publicado en: | Respiratory Care Vol. 60; no. 5; pp. 666 - 673 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
May2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=102727844&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 102727844 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: May2015 vid: 60 iid: 5 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 102727844 103800842 103800842 10.4187/respcare.03733 102727844 ppf: 666 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Clinical Predictors of Obesity Hypoventilation Syndrome in Obese Subjects With Obstructive Sleep Apnea. aug: au: Bingol, Zuleyha Pıhtılı, Aylin Cagatay, Penbe Okumus, Gulfer Kıyan, Esen affil: Department of Pulmonary Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey sug: subj: Pickwickian Syndrome Diagnosis Sleep Apnea, Obstructive Pickwickian Syndrome Symptoms Polysomnography Spirometry Hypercapnia Obesity Bicarbonates Prospective Studies Descriptive Statistics Data Analysis Software Chi Square Test Logistic Regression Mann-Whitney U Test Pearson's Correlation Coefficient T-Tests Human Male Female Adult Middle Age Odds Ratio Scales Turkiye Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: BACKGROUND: Arterial blood gas (ABG) analysis is not a routine test in sleep laboratories due to its invasive nature. Therefore, the diagnosis of obesity hypoventilation syndrome (OHS) is underestimated. We aimed to evaluate the differences in subjects with OHS and pure obstructive sleep apnea (OSA) and to determine clinical predictors of OHS in obese subjects. METHODS: Demographics, body mass index (BMI), Epworth Sleepiness Scale score, polysomnographic data, ABG, spirometric measurements, and serum bicarbonate levels were recorded. RESULTS: Of 152 obese subjects with OSA (79 females/73 males, mean age of 50.3 ± 10.6 y, BMI of 40.1 ± 5.6 kg/m2, 51.9% with severe OSA), 42.1% (/; = 64) had OHS. Subjects with OHS had higher BMI (P = .02), neck circumference (P < .001), waist circumference (P < .001), waist/hip ratio (P = .02), Epworth Sleepiness Scale scores (P = .036), ABG and serum bicarbonate levels (P < .001), apnea-hypopnea index (P = .01), oxygen desaturation index (P < .001), and total sleep time with SpO2 < 90% (P < .001) compared with subjects with pure OSA (n = 88). They also had lower daytime PaO2 (P < .001), sleep efficiency (P = .032), mean SpO2 (P < .001), and nadir SpO2 (P < .001) . Serum bicarbonate levels and nadir SpO2 were the only independent predictive factors for OHS. A serum bicarbonate level of > 27 mmol/L as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 76.6%, specificity of 74.6%, positive predictive value of 54.5%, negative predictive value of 88.9%). A nadir SpO2 of < 80% as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 82.8%, specificity of 54.5%, positive predictive value of 56.9%, negative predictive value of 81.4%). When we usedaserum bicarbonate level of > 27 mmol/L and/or a nadir SpO2 of < 80% as a screening measure, only 3 of 64 subjects with OHS were missed. CONCLUSIONS: Serum bicarbonate level and nadir saturation were independent predictive factors for the diagnosis of OHS. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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