METHODS: This prospective cohort study enrolled consecutive stable patients with acute PE who underwent an overnight sleep study within 7 days after diagnosis. Our outcomes were: i) the STOP-Bang questionnaire\'s utility for risk stratification, ii) the discrimination of the STOP-Bang questionnaire categories, iii) the false negative rate of STOP-Bang questionnaire prediction, and iv) the clinical utility of the STOP-Bang questionnaire to exclude OSA. We also calculated the test performance characteristics to predict OSA.
RESULTS: During the study period, 268 patients completed a sleep study. OSA was found in 47% of patients. OSA incidence in low-, moderate-, and high-risk STOP-Bang groups was 22.4%, 48.2%, and 61.5%, respectively (P <0.001). The area under the receiver operating characteristics curve of the STOP-Bang questionnaire for risk of OSA was 0.65. The false negative rate of a low-risk STOP-Bang questionnaire result to rule out OSA was 22.4% and the clinical utility was 21.6%. The sensitivity was 89.8% (97.2% for men and 80.4% for women).
CONCLUSIONS: The STOP-Bang questionnaire showed poor discrimination for the risk of OSA in hospitalized patients with acute symptomatic PE. It had a high false negative rate and a low clinical utility. The STOP-Bang questionnaire had a good sensitivity in men, and might be used to rule out OSA in this population.
方法:这项前瞻性队列研究纳入了连续稳定的急性PE患者,这些患者在诊断后7天内进行了过夜睡眠研究。我们的结果是:i)STOP-Bang问卷对风险分层的效用,ii)STOP-Bang问卷类别的歧视,iii)STOP-Bang问卷预测的假阴性率,和iv)STOP-Bang问卷排除OSA的临床效用。我们还计算了测试性能特征以预测OSA。
结果:在研究期间,268名患者完成了睡眠研究。在47%的患者中发现OSA。OSA发病率低,moderate-,STOP-Bang高危人群为22.4%,48.2%,61.5%,分别(P<0.001)。STOP-BangOSA风险问卷的受试者工作特征曲线下面积为0.65。低风险STOP-Bang问卷结果排除OSA的假阴性率为22.4%,临床实用性为21.6%。敏感性为89.8%(男性为97.2%,女性为80.4%)。
结论:STOP-Bang问卷显示,在急性症状性PE住院患者中,OSA风险的区分度较差。它具有高的假阴性率和低的临床效用。STOP-Bang问卷在男性中具有良好的敏感性,并可能被用来排除该人群中的OSA。