Document Detail


Oximetry alone versus portable polygraphy for sleep apnea screening before bariatric surgery.
MedLine Citation:
PMID:  20052560     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Screening for obstructive sleep apnea (OSA) is recommended as part of the preoperative assessment of obese patients scheduled for bariatric surgery. The objective of this study was to compare the sensitivity of oximetry alone versus portable polygraphy in the preoperative screening for OSA. METHODS: Polygraphy (type III portable monitor) and oximetry data recorded as part of the preoperative assessment before bariatric surgery from 68 consecutive patients were reviewed. We compared the sensitivity of 3% or 4% desaturation index (oximetry alone) with the apnea-hypopnea index (AHI; polygraphy) to diagnose OSA and classify the patients as normal (<10 events per hour), mild to moderate (10-30 events per hour), or severe (>30 events per hour). RESULTS: Using AHI, the prevalence of OSA (AHI > 10 per hour) was 57.4%: 16.2% of the patients were classified as severe, 41.2% as mild to moderate, and 42.6% as normal. Using 3% desaturation index, 22.1% were classified as severe, 47.1% as mild to moderate, and 30.9% as normal. With 4% desaturation index, 17.6% were classified as severe, 32.4% as mild, and 50% as normal. Overall, 3% desaturation index compared to AHI yielded a 95% negative predictive value to rule out OSA (AHI > 10 per hour) and a 100% sensitivity (0.73 positive predictive value) to detect severe OSA (AHI > 30 per hour). CONCLUSIONS: Using oximetry with 3% desaturation index as a screening tool for OSA could allow us to rule out significant OSA in almost a third of the patients and to detect patients with severe OSA. This cheap and widely available technique could accelerate preoperative work-up of these patients.
Authors:
Maude Malbois; Vittorio Giusti; Michel Suter; Cyril Pellaton; Jean-Fr?d?ric Vodoz; Raphael Heinzer
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-01-06
Journal Detail:
Title:  Obesity surgery     Volume:  20     ISSN:  1708-0428     ISO Abbreviation:  Obes Surg     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-23     Completed Date:  2010-05-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  326-31     Citation Subset:  IM    
Affiliation:
University of Lausanne, Lausanne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bariatric Surgery
Female
Humans
Male
Middle Aged
Obesity, Morbid / physiopathology*,  surgery
Oximetry* / standards
Polysomnography* / standards
Predictive Value of Tests
Preoperative Period
Prevalence
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Sleep Apnea, Obstructive / diagnosis*,  epidemiology,  pathology
Young Adult

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