目的:阻塞性睡眠呼吸暂停风险的四个公认的预测因子是体重指数,年龄,性别,和颈围。我们以前报道过脸颊外观作为OSA预测因子,它们可以在单个容易获得的特征中表示这些预测因子的组合。这项研究试图回答以下问题:脸颊外观是OSA风险预测因子吗?
方法:基于STARD的前瞻性横断面诊断准确性研究。在大学医院附属的睡眠诊所接受多导睡眠图检查以调查睡眠投诉的患者,使用脸颊外观对体积评分为0-3,松弛评分为0-3,以创建睡眠呼吸暂停(CASA)评分范围为0-6。外观由三名盲目和独立的评估者判断。
结果:在接受评估的265例患者中,248人包括在内。57名患者的CASA评分为0,191名患者的CASA评分在1-6之间。多导睡眠图诊断出177例OSA患者;其中167例CASA评分改变。敏感度为87%,特异性82%,阳性预测值94%,阴性预测值66%,准确率86%。
结论:我们的结果表明,将脸颊外观的体积和松弛性结合在一个指标中可能构成可靠的OSA预测指标。CASA评分是睡眠实验室成年人群中阻塞性睡眠呼吸暂停的新预测指标。我们的发现支持进一步的研究,以证实这种实用诊断工具的外部有效性。
背景:注册表:ClinicalTrials.gov;标题:脸颊作为阻塞性睡眠呼吸暂停的新型预测因子的外观:CASA评分研究(CASA);标识符:NCT04980586;URL:https://clinicaltrials.gov/study/NCT04980586。
OBJECTIVE: Four well-established predictors of obstructive sleep apnea (OSA) risk are body mass index, age, sex, and neck circumference. We have previously reported cheeks appearance as an OSA predictor, which may represent a combination of such predictors in a single, readily available feature. This
study sought to answer the question: Is cheeks appearance an OSA risk predictor?
METHODS: This was a prospective cross-sectional diagnostic accuracy
study based on STARD (standards for reporting diagnostic accuracy studies). Patients undergoing polysomnography to investigate sleep complaints at a sleep clinic affiliated with a university hospital were assessed using cheeks appearance scored 0-3 for volume and 0-3 for flaccidity to create the Cheeks Appearance for Sleep Apnea (CASA) score ranging from 0 to 6. Appearance was judged by 3 blinded and independent evaluators.
RESULTS: Among 265 patients evaluated, 248 were included. Fifty-seven patients had a CASA score of 0 and 191 had a CASA score between 1 and 6. Polysomnography diagnosed 177 of the individuals with OSA; of these, 167 had an altered CASA score. Sensitivity was 87%, specificity was 82%, positive-predictive value was 94%, negative-predictive value was 66%, and accuracy was 86%.
CONCLUSIONS: Our results suggest that combining volume and flaccidity of cheeks appearance in a single index may constitute a reliable OSA predictor. CASA score is a novel predictor of OSA with internal validity in a sleep laboratory adult population. Our findings support further studies to confirm the external validity of this practical diagnostic tool.
BACKGROUND: Registry: ClinicalTrials.gov; Name: Cheeks Appearance as a Novel Predictor of Obstructive Sleep Apnea: The CASA Score
Study (CASA); URL: https://clinicaltrials.gov/
study/NCT04980586; Identifier: NCT04980586.
BACKGROUND: Prikladnicki A, Gomes E, Sousa LCCR, Gonçalves SC, Martinez D. Cheeks appearance as a novel predictor of obstructive sleep apnea: the CASA score
study. J Clin Sleep Med. 2024;20(6):879-885.