| ObjectivesTo clarify the clinical application value of the STOP-BANG questionnaire for screening obstructive sleep apnea-hypopnea syndrome(OSAHS)high-risk population in patients with atrial fibrillation(AF),and provide clinical reference and basis for the application of the STOP-BANG questionnaire for screening OSAHS in patients with AF.Methods63 patients diagnosed with AF in our hospital were included in the study.All patientscompleted the STOP-BANG questionnaire and polysomnography(PSG).ResultsAmong 63 patients,Age(62.4±10.7)years old,systolic blood pressure(123.0±18.2)mm Hg,diastolic blood pressure(74.0±11.2)mm Hg,BMI(25.3±3.5)kg/m~2,neck circumference(38.5±3.7)cm,triglyceride1.3(1.0-2.0)mmol/L,cholesterol(3.9±1.2)mmol/L,LDL-C2.6(2.0-3.1)mmol/L,Scr(77.5±17.4)μmol/L,uric acid349.3(285.4-424.1)μmol/L,fasting plasma glucose5.1(4.8-5.6)mmol/L.There were 32 males(50.79%),31 females(49.21%),29 hypertension(46.03%),11 diabetes(17.46%),8 coronary heart disease(12.70%),16 hyperlipidemia(25.40%),17 hyperuricemia(26.98%),5 heart failure(7.94%),and 16 smoking(25.40%).The score of the STOP-BANG questionnaire in 63 patients with AF was 4(3-5)points.According to PSG,there were 52 OSAHS patients and 11 non-OSAHS patients.Among them,17 cases were mild OSAHS,18 cases were moderate OSAHS,and 17 cases were severe OSAHS.The age and BMI of OSAHS patients were higher than that of non-OSAHS patients,the proportion of postmenopausal women and taking statins patients was higher.The levels of total cholesterol and LDL cholesterol were lower.With the score of STOP-BANG questionnaire as the independent variable and AHI as the dependent variable,the ROC curve analysis showed that the area under the curve(AUC)was 0.705(95%CI 0.519-0.892),the cut-off point was 2.5 points and the Youden index was 0.40.Since the score of STOP-BANG is a discontinuous variable,the score around the cut-off point is taken for analysis.Compared with the results of PSG,the sensitivity,specificity,false positive rate,false negative rate,positive predictive value,negative predictive value,and Youden index of ≥2 points of the STOP-BANG questionnaire to the diagnosis of OSAHS were 100%,36.4%,63.6%,0%,100%,36.4% and 0.364.The sensitivity,specificity,false positive rate,false negative rate,positive predictive value,negative predictive value and Youden index of≥3 points of the STOP-BANG questionnaire to the diagnosis of OSAHS were 94.2%,45.5%,54.5%,5.8%,89.1%,62.5% and 0.397.Spearman correlation analysis showed that there was a significant positive correlation between the score of STOP-BANG questionnaire and AHI(r=0.449,P <0.001).After adjusting for age and BMI,it still showed that the score of STOP-BANG questionnaire was an important influencing factor or factor of AHI(all P < 0.05).Eight items of the STOP-BANG questionnaire were evaluated,with the diagnosis of OSAHS as the dependent variable and each item as the independent variable for binary Logistic regression analysis,showing no statistical difference in Wald test.Binary Logistic regression analysis was conducted with the diagnosis of OSAHS as the dependent variable,the score of STOP-BANG questionnaire ≥ 2 points,age and BMI as independent variables,indicating that the score of STOP-BANG questionnaire ≥2points was not a predictor of OSAHS.Binary Logistic regression analysis was conducted with the diagnosis of OSAHS as the dependent variable,the score of STOP-BANG questionnaire ≥ 3 points,age and BMI as independent variables,indicating that the score of STOP-BANG questionnaire ≥3 points is a predictor of OSAHS.ConclusionsThe STOP-BANG questionnaire has the characteristics of high sensitivity,high accuracy and simplicity in screening OSAHS in patients with AF,which can be used as a screening tool for OSAHS in patients with AF in clinical practice.STOP-BANG score ≥3 points is the best diagnostic cut-off point for patients with AF complicated with OSAHS,and patients with score ≥3 points should be recommended to receive PSG to confirm the diagnosis of OSAHS. |
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