Failure to complete diagnostic testing in patients with suspected obstructive sleep apnoea and inconclusive home sleep apnoea test.

IF 2
Marcus Jin Hui Sim, Yvonne Poh, Hang Siang Wong, Yingjuan Mok
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Abstract

Purpose: Home sleep apnoea test (HSAT) is an effective diagnostic test for obstructive sleep apnoea (OSA). However, a proportion of patients who undergo HSAT may obtain an inconclusive result and require further diagnostic testing. Our objective is to evaluate the proportion of patients who have an inconclusive HSAT and complete diagnostic testing with an in-laboratory polysomnogram.

Methods: Patients who had HSAT performed for suspected OSA and obtained an inconclusive test (technically inadequate study or low pAHI less than 5) were included. Rates of completion of diagnostic testing, factors associated with completion of diagnostic testing and rates of OSA in patients who completed diagnostic testing were evaluated.

Results: 139 patients (106 male and 33 female, age 38 ± 27, body mass index 25.6 ± 7.9 kg/m2) with inconclusive HSAT were included. Only 35 patients (25.2%) completed diagnostic testing after the inconclusive HSAT. Multivariate analysis showed male gender, individuals at elevated risk of moderate to severe OSA and those who were previously counseled about the need for repeat testing had significantly higher odds of completing diagnostic testing. 20 out of 35 patients (57%) who completed diagnostic testing had moderate to severe OSA.

Conclusion: A considerable percentage of patients with an inconclusive HSAT failed to complete diagnostic testing, which puts them at risk of missing out on a diagnosis of OSA and potential treatment. Physicians should be aware of this limitation when choosing a diagnostic test for suspected OSA.

Abstract Image

疑似阻塞性睡眠呼吸暂停的患者未能完成诊断测试和不确定的家庭睡眠呼吸暂停测试。
目的:家庭睡眠呼吸暂停测试(HSAT)是诊断阻塞性睡眠呼吸暂停(OSA)的有效方法。然而,一部分接受HSAT的患者可能会得到不确定的结果,需要进一步的诊断测试。我们的目的是评估有不确定的HSAT和完成实验室多导睡眠图诊断测试的患者的比例。方法:纳入了因疑似OSA而进行HSAT检查但结果不确定(技术上研究不充分或pAHI低于5)的患者。评估完成诊断测试的患者的诊断测试完成率、与诊断测试完成率相关的因素以及OSA的发生率。结果:139例患者(男106例,女33例,年龄38±27岁,体重指数25.6±7.9 kg/m2) HSAT不确定。只有35名患者(25.2%)在不确定的HSAT后完成了诊断测试。多变量分析显示,男性、中度至重度OSA风险较高的个体以及之前被告知需要重复检测的个体完成诊断检测的几率明显更高。完成诊断测试的35名患者中有20名(57%)患有中度至重度OSA。结论:相当大比例的HSAT不确定患者未能完成诊断测试,这使他们有错过OSA诊断和潜在治疗的风险。医生在选择诊断性阻塞性睡眠呼吸暂停的检查方法时应注意这一局限性。
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