A new tool to screen patients with severe obstructive sleep apnea in the primary care setting : a prospective multicenter study
Peñacoba, Patricia (Institut d'Investigació Biomèdica Sant Pau)
Llauger, Maria Antònia (Institut Català de la Salut)
Fortuna Gutiérrez, Ana Mª (Institut d'Investigació Biomèdica Sant Pau)
Flor Escriche, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)
Sampol, Gabriel (Hospital Universitari Vall d'Hebron)
Pedro-Pijoan, Anna Maria (Institut Català de la Salut)
Grau, Núria (Institut Hospital del Mar d'Investigacions Mèdiques)
Santiveri, Carme (Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona)
Juvanteny, Joan (Universitat Autònoma de Barcelona. Departament de Medicina)
Aoiz, José Ignacio (Institut Català de la Salut)
Bayó, Joan (Institut Català de la Salut)
Lloberes, Patricia (Hospital Universitari Vall d'Hebron)
Mayos, Mercè (Institut d'Investigació Biomèdica Sant Pau)

Fecha:	2022
Resumen:	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.
Ayudas:	Instituto de Salud Carlos III PI14/01985
Nota:	Altres ajuts: Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Societat Catalana de Pneumologia (SOCAP).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Obstructive sleep apnea ; Continuous positive airway pressure (CPAP) ; Primary healthcare ; Sleep unit ; Screening model ; Home sleep apnea test
Publicado en:	BMC Pulmonary Medicine, Vol. 22 (january 2022) , ISSN 1471-2466

DOI: 10.1186/s12890-022-01827-0
PMID: 35033055

10 p, 1.1 MB

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