Predictores clínicos de IAH = 15/hora en la poligrafía respiratoria

Objetivos: Identificar variables clinicas para la prediccion de un indice de apneas e hipopneas (IAH) ≥ 15/hora de registro en pacientes derivados para la realizacion de una poligrafia respiratoria (PR). Material y metodos: Estudio prospectivo conducido entre enero del 2010 y marzo del 2012 en 614 pacientes referidos para exploracion respiratoria del sueno. Los registrosde PR (nivel III) se tomaron en domicilio una noche con tecnica de auto-colocacion. Se correlacionaron con datos antropometricos del cuestionario de Berlin y la escala de somnolencia subjetiva de Epworth (ESS). Se definio obesidad por un indice de masa corporal (IMC) > 30 y se considero relevante un indice de apneas e hipopneas por horade registro ≥ 15 eventos/hora. Se ejecuto un analisis para los siguientes factores de prediccion: IMC (> 30), edad mayor de 50 anos, nivel educativo (primario o mayor), cuestionario de Berlin (alto o bajo riesgo) y ESS > 10. Se analizaron los datos mediante regresion logistica para factores de prediccion de un IAH ≥ 15 /hora.Resultados: Se estudiaron 614 pacientes, 392 hombres (63.8%) y 222 mujeres con una media de edad de 54.9 anos. El IMC en 284 pacientes (46.25 %) fue 10 puntos. En 235 poligrafias respiratorias se encontro un IAH > 15/hora (38.27%). El analisis de predictores independientes en toda la poblacion arrojo significacion parasexo masculino, IMC > 30 y edad > 50 anos. Sin embargo no resulto significativo el cuestionario de Berlin de alto riesgo: OR 1.17 (CI 95% 0.63-2.17) p = 0.605, ni el ESS >10: OR 1.35 (CI 95% 0.93-1.97) p = 0.113. El analisis diferencial entre ambos generos demostro diferencias en la significacion para la edad (mujeres; p = 0.015 y hombres; p = 0.007) y el IMC (mujeres: 0.027 y hombres: 0.0001). La regresion logistica mostro como predictores independientes de un ... Objectives: To identify the predictive value of variable risk factors for the diagnosis of clinically significant obstructive sleep apnea (apnea-hypopnea index ≥15 / hour) in a population referred for respiratory polygraphy (RP). Material and methods: Between January 2010 and March 2012 we studied prospectively 614 adult patients referred to our sleep clinic for the study of sleep respiratory disorders. The patients completed Berlin and Epworth questionnaires and were monitored by a level III respiratory polygraphy using a self placement method at home during one night. Results were correlated with demographic and anthropometric data. Obesity was defined as a body mass index (BMI) > 30. Clinically significantobstructive sleep apnea (OSA) was diagnosed if the patient was found to have an apnea - hypopnea index (AHI) greater than ≥ 15 per hour. The analysis included BMI (> 30), age (> 50 years), educational level (primary school or more), Berlin questionnaire (high or low risk) and Epworth Sleepness Scale (> 10). Data were analyzed through logistic regression for factors predicting AHI ≥15 / hour. Results: 614 patients (392 men (63.8%), 222 women) with a mean age of 54.9 years old wereincluded. High risk OSA according to Berlin questionnaire was identified in 536 subjects (87.3%) while only 207 (33.7%) had an Epworth score > 10 points. 330 subjects (53.74%) had a body mass index > 30. IAH > 15 / hour was diagnosed in 235 respiratory poligraphies (38.27%). Logistic regression analysis showed that three independent predictors were significant for the diagnosis of clinically significant OSA: male sex: OR 3.63 (CI 95%: 2.43 to 5.43) p = 0.0001; BMI > 30: OR 2.45 (CI 95% 1.69 to 3.56) p = 0.0001), and age > 50 years: OR 2.05 (CI 95% 1.39 to 3.02) p = 0.0001). We did not find significance for Berlin's high risk questionnaire: OR 1.17(CI 95%0.63 to 2.17) p = 0.605, nor for the Epworth score > 10: OR 1.35 (CI 95% 0.93 to 1.97) p = 0.113 ...