000			02255cam a2200217 4500
001			NMDX5881
008			120401t2013 xxu||||| |||| 00| 0 eng d
022			_a15509389
100			_aMacavei, VM.
240			_aJournal of clinical sleep medicine
245			_aDiagnostic predictors of obesity-hypoventilation syndrome in patients suspected of having sleep disordered breathing.
260			_c2013
500			_aNMUH Staff Publications
500			_a9
520			_a<div><p>INTRODUCTION: Obesity-hypoventilation syndrome (OHS) is associated with significant morbidity and mortality and requires measurement of arterial pCO2 for diagnosis.</p><p>OBJECTIVE: To determine diagnostic predictors of OHS among obese patients with suspected obstructive sleep apnea/hypopnea syndrome (OSAHS).</p><p>METHODS: Retrospective analysis of data on 525 sleep clinic patients (mean age 51.4 ± 12.7 years; 65.7% males; mean BMI 34.5 ± 8.1). All patients had sleep studies, and arterialized capillary blood gases (CBG) were measured in obese subjects (BMI > 30 kg/m2).</p><p>RESULTS: Of 525 patients, 65.5% were obese, 37.2% were morbidly obese (BMI > 40 kg/m2); 52.3% had confirmed OSAHS. Hypercapnia (pCO2 > 6 kPa or 45 mm Hg) was present in 20.6% obese and 22.1% OSAHS patients. Analysis of OHS predictors showed significant correlations between pCO2 and BMI, FEV1, FVC, AHI, mean and minimum nocturnal SpO2, sleep time with SpO2 < 90%, pO2, and calculated HCO3 from the CBG. PO2 and HCO3 were independent predictors of OHS, explaining 27.7% of pCO2 variance (p < 0.0001). A calculated HCO3 cutoff > 27 mmol/L had 85.7% sensitivity and 89.5% specificity for diagnosis of OHS, with 68.1% positive and 95.9% negative predictive value.</p><p>CONCLUSION: We confirmed a high prevalence of OHS in obese OSAHS patients (22.1%) and high calculated HCO3 level (> 27 mmol/L) to be a sensitive and specific predictor for the diagnosis of OHS.</p></div>
700			_aSpurling, KJ.
700			_aLoft, J.
700			_aMakker, HK.
856			_uhttp://www.ncbi.nlm.nih.gov/pubmed/23997700?dopt=Abstract
856			_uhttp://europepmc.org/journals/920
999			_c75396 _d75396