Clinical predictors of obstructive sleep apnea in Asian bariatric patients.
BACKGROUND
Obstructive sleep apnea (OSA) is a common disorder in modern society and closely associated with obesity. Because OSA increases the likelihood of complications in the perioperative period, preoperative recognition is very important for bariatric patients. Polysomnography (PSG) remains the gold standard for diagnosis, but it is a time-consuming and expensive examination. Our study is aimed at identifying practical clinical predictors of OSA for bariatric patients.


METHODS
From April 2006 to December 2007, 101 morbid obese patients [41 men and 60 women, mean age 30.3 +/- 8.5, mean body mass index (BMI) 43.3 +/- 6.9] who underwent PSG before bariatric surgery were retrospectively studied. The severity of OSA was categorized by the apnea-hypopnea index (AHI) as follows: normal, 0 to 4.9; mild, 5 to 14.9; moderate, 15 to 29.9; and severe, >/=30. Chi-squared tests and linear regression models were used to assess associations between clinical parameters and AHI; P < 0.05 was considered statistically significant.


RESULTS
The mean Epworth sleepiness scale (ESS) score was 8.2 +/- 4.7, and the mean AHI was 28.9 +/- 33.8 per hour. Of 101 patients, 83 patients had OSA; including severe (32.7%), moderate (17.8%), and mild (31.7%) OSA; 18.5% had no OSA. Patients with severe OSA are significantly male predominant and had higher BMI, systolic blood pressure, hemoglobin, neck and waist circumference, and ESS scores. In linear regression model analysis, the parameters which positively correlated with AHI were body weight, BMI, systolic blood pressure, diastolic blood pressure, hemoglobin, waist and neck circumferences, and the scores of ESS. Multivariate analysis confirmed that BMI, neck circumference, and scores of ESS are independent predictors of the increasing of AHI.


CONCLUSIONS
OSA is highly prevalent (82.2%) in Asian bariatric patients. BMI, neck circumference, and scores of ESS are independent predictors of OSA in these patients.
Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China.
Pu-Sheng
PS
Yeh
Yi-Chih
YC
Lee
Wei-Jei
WJ
Lee
Sheng-Bin
SB
Chen
Sung-Jung
SJ
Ho
Wei-Ban
WB
Peng
Ching-Ching
CC
Tsao
Hui-Ling
HL
Chiu
D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009333:Neck / Q000033:anatomy & histology; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult