Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors
Introduction In adults with cardiovascular risk factors undergoing major noncardiac surgery, unrecognized obstructive sleep apnea (OSA) was associated with postoperative cardiovascular complications. There is a need for an easy and accessible home device in predicting sleep apnea. The objective of t...
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my.um.eprints.280382022-07-18T07:42:44Z http://eprints.um.edu.my/28038/ Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors Waseem, Rida Chan, Matthew T. V. Wang, Chew Yin Seet, Edwin Chung, Frances R Medicine (General) Introduction In adults with cardiovascular risk factors undergoing major noncardiac surgery, unrecognized obstructive sleep apnea (OSA) was associated with postoperative cardiovascular complications. There is a need for an easy and accessible home device in predicting sleep apnea. The objective of the study is to determine the predictive performance of the overnight pulse oximetry in predicting OSA in at-risk surgical patients. Methods This was a planned post-hoc analysis of multicenter prospective cohort study involving 1,218 at-risk surgical patients without prior diagnosis of sleep apnea. All patients underwent home sleep apnea testing (ApneaLink Plus, ResMed) simultaneously with pulse oximetry (PULSOX-300i, Konica Minolta Sensing, Inc). The predictive performance of the 4% oxygen desaturation index (ODI) versus apnea-hypopnea index (AHI) were determined. Results Of 1,218 patients, the mean age was 67.2 9.2 years and body mass index (BMI) was 27.0 +/- 5.3 kg/m(2). The optimal cut-off for predicting moderate-to-severe and severe OSA was ODI >= 15 events/hour. For predicting moderate-to-severe OSA (AHI >= 15), the sensitivity and specificity of ODI >= 15 events per hour were 88.4% (95% confidence interval CI], 85.7-90.6) and 95.4% (95% CI, 94.2-96.4). For severe OSA (AHI >= 30), the sensitivity and specificity were 97.2% (95% CI, 92.7-99.1) and 78.8% (95% CI, 78.2-79.0). The area under the curve (AUC) for moderate-to-severe and severe OSA was 0.983 (95% CI, 0.977-0.988) and 0.979 (95% CI, 0.97-0.909) respectively. Discussion ODI from oximetry is sensitive and specific in predicting moderate-to-severe or severe OSA in at-risk surgical population. It provides an easy, accurate, and accessible tool for at-risk surgical patients with suspected OSA. Public Library of Science 2021-05-06 Article PeerReviewed Waseem, Rida and Chan, Matthew T. V. and Wang, Chew Yin and Seet, Edwin and Chung, Frances (2021) Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors. PLoS ONE, 16 (5). ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0250777 <https://doi.org/10.1371/journal.pone.0250777>. 10.1371/journal.pone.0250777 |
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R Medicine (General) Waseem, Rida Chan, Matthew T. V. Wang, Chew Yin Seet, Edwin Chung, Frances Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors |
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Introduction In adults with cardiovascular risk factors undergoing major noncardiac surgery, unrecognized obstructive sleep apnea (OSA) was associated with postoperative cardiovascular complications. There is a need for an easy and accessible home device in predicting sleep apnea. The objective of the study is to determine the predictive performance of the overnight pulse oximetry in predicting OSA in at-risk surgical patients. Methods This was a planned post-hoc analysis of multicenter prospective cohort study involving 1,218 at-risk surgical patients without prior diagnosis of sleep apnea. All patients underwent home sleep apnea testing (ApneaLink Plus, ResMed) simultaneously with pulse oximetry (PULSOX-300i, Konica Minolta Sensing, Inc). The predictive performance of the 4% oxygen desaturation index (ODI) versus apnea-hypopnea index (AHI) were determined. Results Of 1,218 patients, the mean age was 67.2 9.2 years and body mass index (BMI) was 27.0 +/- 5.3 kg/m(2). The optimal cut-off for predicting moderate-to-severe and severe OSA was ODI >= 15 events/hour. For predicting moderate-to-severe OSA (AHI >= 15), the sensitivity and specificity of ODI >= 15 events per hour were 88.4% (95% confidence interval CI], 85.7-90.6) and 95.4% (95% CI, 94.2-96.4). For severe OSA (AHI >= 30), the sensitivity and specificity were 97.2% (95% CI, 92.7-99.1) and 78.8% (95% CI, 78.2-79.0). The area under the curve (AUC) for moderate-to-severe and severe OSA was 0.983 (95% CI, 0.977-0.988) and 0.979 (95% CI, 0.97-0.909) respectively. Discussion ODI from oximetry is sensitive and specific in predicting moderate-to-severe or severe OSA in at-risk surgical population. It provides an easy, accurate, and accessible tool for at-risk surgical patients with suspected OSA. |
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Article |
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Waseem, Rida Chan, Matthew T. V. Wang, Chew Yin Seet, Edwin Chung, Frances |
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Waseem, Rida Chan, Matthew T. V. Wang, Chew Yin Seet, Edwin Chung, Frances |
author_sort |
Waseem, Rida |
title |
Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors |
title_short |
Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors |
title_full |
Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors |
title_fullStr |
Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors |
title_full_unstemmed |
Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors |
title_sort |
predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors |
publisher |
Public Library of Science |
publishDate |
2021 |
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http://eprints.um.edu.my/28038/ |
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1739828428286197760 |