The NH-OSA score in prediction of clinically significant obstructive sleep apnea among the Thai population: derivation and validation studies,Sleep and Breathing

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The NH-OSA score in prediction of clinically significant obstructive sleep apnea among the Thai population: derivation and validation studies
Sleep and Breathing ( IF 2.1 ) Pub Date : 2022-07-27 , DOI: 10.1007/s11325-022-02642-x
Supakorn Srichan ₁ , Jeerath Phannajit ₂ , Somkanya Tungsanga ₃ , Nattapong Jaimchariyatam _{1,

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Affiliation

Background

Diagnosis of obstructive sleep apnea requires polysomnography which has limited availability. We aimed to develop and validate a risk score in predicting clinically significant OSA among the Thai population.

Methods

We reviewed polysomnographic studies performed in adults diagnosed with OSA in King Chulalongkorn Memorial Hospital from 2017 to 2019. 1798 and 450 patients were randomly enrolled in development and validation cohorts, respectively. A risk score was developed using multiple factor analysis and logistic regression. The NH-OSA score was externally validated at the Bangkok Christian Hospital. We compared its performance to existing screening scores (STOP-BANG, Berlin Questionnaire, Epworth Sleepiness Scale (ESS), and NoSAS score).

Result

The NH-OSA score allocates 1 point for having neck circumference ≥ 13 inches (in women) or 15 inches (in men), 4 points for the presence of hypertension, 3 or 5 or 7 points for having a body mass index of 23–24.9, 25–30, ≥ 30 kg/m², respectively, 9 points for the presence of moderate or severe snoring, and 5 points for age ≥ 40 years. With a cutoff value at 14 points, the sensitivity and specificity were 82.1% and 68.7%, respectively. The AUC was 0.75 (0.73–0.78). Both internal and external validation study revealed high AUC of 0.74 (0.68–0.80) and 0.75 (0.60–0.90), respectively. These were greater when compared to STOP-BANG, Berlin Questionnaire, ESS, and NoSAS score.

Conclusion

NH-OSA is a newly developed tool which has good performance in predicting clinically significant OSA with high validity among the Thai population. It could help screen patients at risk of OSA for further investigation.

中文翻译：

NH-OSA 评分预测泰国人群临床显着阻塞性睡眠呼吸暂停：推导和验证研究

背景

阻塞性睡眠呼吸暂停的诊断需要多导睡眠图，但可用性有限。我们旨在开发和验证风险评分，以预测泰国人群中具有临床意义的 OSA。

方法

我们回顾了 2017 年至 2019 年在朱拉隆功国王纪念医院对诊断为 OSA 的成人进行的多导睡眠图研究。分别有 1798 名和 450 名患者被随机纳入开发队列和验证队列。使用多因素分析和逻辑回归开发风险评分。NH-OSA 评分在曼谷基督教医院进行了外部验证。我们将其性能与现有筛查评分（STOP-BANG、柏林问卷、Epworth 嗜睡量表 (ESS) 和 NoSAS 评分）进行了比较。

结果

NH-OSA 评分为颈围≥ 13 英寸（女性）或 15 英寸（男性）分配 1 分，存在高血压为 4 分，体重指数为 23-3 或 5 或 7 分24.9、25-30、≥30 kg/m ²分别为中度或重度打鼾9分，年龄≥40岁5分。以 14 个点为截止值，敏感性和特异性分别为 82.1% 和 68.7%。AUC 为 0.75 (0.73–0.78)。内部和外部验证研究均显示高 AUC 分别为 0.74 (0.68–0.80) 和 0.75 (0.60–0.90)。与 STOP-BANG、柏林问卷调查、ESS 和 NoSAS 评分相比，这些评分更高。