Abstract
BackgroundTo evaluate the effect of arterial bicarbonate (HCO3−) concentration on the accuracy of STOP-Bang questionnaire (SBQ) screening for obstructive sleep apnea (OSA).MethodsA total of 144 patients with suspected OSA were included. Polysomnograms (PSG) and blood gas analysis were performed, and the Epworth Sleepiness Scale (ESS), STOP-Bang questionnaire, and Berlin questionnaire were completed. The correlation between the arterial HCO3− concentration, apnea hypopnea index (AHI), and other related indicators was analyzed. The scoring results of the ESS, SBQ, and Berlin questionnaire were compared with the PSG results, and the sensitivity and specificity were calculated in the form of a four-cell table. The changes in the sensitivity and specificity of OSA screening after SBQ alone and combined with HCO3− concentration were compared, and ROC curves were drawn.ResultsArterial HCO3− concentration was positively correlated with AHI (r = 0.537, P < 0.001). The ratio of HCO3− concentration ≥ 24.6 mmol/L in the non-OSA group was significantly lower than that in the OSA group (25.0% VS 80.8%, P < 0.001). The sensitivity of the SBQ was higher than that of the ESS (97.5% VS 81.7%, P < 0.001) and the Berlin questionnaire (97.5% VS 79.2%, P < 0.001). There was no statistical significance in the specificity of the three scales (25%, 37.5%, 37.5%). A combined SBQ score ≥ 3 and HCO3− concentration ≥ 24.6 mmol/L showed increased specificity and decreased sensitivity compared with an SBQ score ≥ 3 alone, with a corresponding AUC of 0.771 (P < 0.01) and 0.613 (P > 0.05), respectively.ConclusionThe sensitivity of the SBQ was better than that of the Berlin questionnaire and ESS. After combining arterial blood HCO3− concentration, the SBQ questionnaire increased the specificity of OSA prediction and decreased the sensitivity, which improved the accuracy of screening.
Highlights
To evaluate the effect of arterial bicarbonate (HCO3−) concentration on the accuracy of STOP-Bang questionnaire (SBQ) screening for obstructive sleep apnea (OSA)
A combined STOP-Bang Questionnaire (SBQ) score ≥ 3 and HCO3− concentration ≥ 24.6 mmol/L showed increased specificity and decreased sensitivity compared with an SBQ score ≥ 3 alone, with a corresponding area under the ROC curve (AUC) of 0.771 (P < 0.01) and
BMI = body mass index, AHI = apnea hypopnea index, CT90% = percentage of total sleep time when blood oxygen is less than 90%, AHT% = duration of apnea hypopnea in total sleep time, mean apnea-hypopnea duration (MAD) = mean apnea–hypopnea duration, Duration of apnea hypopnea per hour (HAD) = duration of apnea hypopnea per hour, Lowest blood oxygen saturation (LSaO2) = lowest blood oxygen saturation, Mean blood oxygen saturation (MSaO2) = mean blood oxygen saturation, SBQ = STOP-Bang questionnaire, ESS = Epworth Sleepiness Scale
Summary
To evaluate the effect of arterial bicarbonate (HCO3−) concentration on the accuracy of STOP-Bang questionnaire (SBQ) screening for obstructive sleep apnea (OSA). Some questionnaire results are inconsistent with the gold standard, which delays the diagnosis and treatment of real OSA patients. The Berlin Questionnaire, STOP-Bang Questionnaire (SBQ), and Epworth Sleepiness Scale (ESS) are widely used in OSA screening and have good sensitivity [3, 4]. The combination of H CO3− and a questionnaire is hypothesized to improve the sensitivity or specificity of questionnaires alone [6] The purpose of this current study is to improve the screening efficiency of OSA through the combination of arterial blood HCO3− and a questionnaire, to facilitate the diagnosis and treatment of OSA patients earlier in future clinical work. This study compared the difference between the SBQ, the Berlin questionnaire, and the ESS screening for patients with OSA, and examined the effect of arterial HCO3− concentration on SBQ screening
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