OBJECTIVE: Determine the ideal OSA screening tool for bariatric surgery patients balancing accuracy and cost-effectiveness.
METHODS: University Hospital.
METHODS: Bariatric surgery patients from January 2018 to September 2023 were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. For patients with a STOP-Bang score of ≥4 referred for polysomnogram additional variables were collected from the electronic medical record. The Berlin Score was retrospectively calculated.
RESULTS: Out of 484 patients who underwent bariatric surgery, 167 (34.5%) had a STOP-Bang score ≥4. The receiver operating characteristic (ROC) curve for STOP-Bang scores ≥4 had an area under the curve (AUC) of 78.5% for predicting OSA and 83.7% for OSA requiring treatment (Apnea Hypopnea Index [AHI] ≥ 15), compared to Berlin Scores\' AUC of 80.7% and 88.6%, respectively. A STOP-Bang score of 4 had a sensitivity of 55.6% and specificity of 36.8%, while a score of 5 had 29.3% and 66.2%, respectively. A Berlin Score of 3 had a sensitivity of 47.5% and specificity of 69.1%, with 30 patients (44.1%) starting OSA treatment. Thirty-five patients (21%) experienced a delay in insurance submission, averaging 41.5 days, related to OSA workup.
CONCLUSIONS: The Berlin questionnaire outperforms STOP-Bang in predicting OSA requiring treatment. Raising the polysomnography referral score from STOP-Bang ≥4 to ≥5 or utilizing a Berlin Score of ≥3, may alleviate resource burden, reduce costs, and expedite medical optimization for bariatric surgery.
目的:为减肥手术患者确定理想的OSA筛查工具,以平衡准确性和成本效益。
方法:大学医院。
方法:从代谢和减重手术认证和质量改进计划(MBSAQIP)数据库中确定了2018年1月至2023年9月的减重手术患者。对于多导睡眠图的STOP-Bang评分≥4的患者,从电子病历中收集了其他变量。柏林评分是回顾性计算的。
结果:在484名接受减肥手术的患者中,167人(34.5%)的STOP-Bang评分≥4。STOP-Bang评分≥4的受试者工作特征(ROC)曲线的曲线下面积(AUC)为78.5%,对于需要治疗的OSA为83.7%(呼吸暂停低通气指数[AHI]≥15),与柏林的80.7%和88.6%的AUC相比,分别。STOP-Bang评分为4分,敏感性为55.6%,特异性为36.8%,5分分别为29.3%和66.2%,分别。柏林得分为3分的敏感性为47.5%,特异性为69.1%,30例患者(44.1%)开始OSA治疗。35名患者(21%)经历了保险提交延迟,平均41.5天,与OSA检查有关。
结论:柏林问卷在预测OSA需要治疗方面优于STOP-Bang。将多导睡眠图转诊评分从STOP-Bang≥4提高到≥5或利用柏林评分≥3可以减轻资源负担。降低成本,加快减肥手术的医疗优化。