RemLogic plug-in enables clinical application of apnea-hypopnea index adjusted for severity of individual obstruction events
RemLogic plug-in enables clinical application of apnea-hypopnea index adjusted for severity of individual obstruction events
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DOI：
10.3109/03091902.2016.1148791
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发表时间：
2016-04-02
影响因子：
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通讯作者：
Toyras, Juha
中科院分区：
文献类型：
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作者：
Leppanen, Timo;Sarkka, Mikko;Toyras, Juha
阻塞性睡眠呼吸暂停（OSA）是根据阻塞事件的发生率来诊断的，尽管个别阻塞事件的严重程度与死亡率增加有关。调整后的 AHI 参数结合了阻塞事件的数量和严重程度，已显示出良好的潜力，但是使用定制的 MATLAB((R)) 函数计算的。为了允许其临床使用，本研究引入了 RemLogic (TM) 插件。测试比较了使用该插件和 MATLAB((R)) 计算的调整后的 AHI 值与 100 名患者。此外，对 1128 名工作年龄男性进行了回顾性随访（平均 +/- SD = 194.1 +/- 54.0 个月），以评估调整后的 AHI 增强 OSA 诊断的潜力。调整后的 AHI 值密切相关（r = 1.000，p < 0.001），并且它们的平均差异（平均值 +/- SD）很小（0.08 +/- 0.19%）。使用调整后的 AHI 来定义 OSA 严重程度会导致严重 OSA 组的死亡率风险比更高，并且首次发现调整后的 AHI 可以独立解释总体死亡率和非致命性心血管事件。重要的是，目前的插件可以在临床上使用调整后的 AHI，从而增强对 OSA 严重程度的评估。
Obstructive sleep apnea (OSA) is diagnosed based on obstruction event incidence, albeit individual obstruction event severity is connected to increased mortality rate. Adjusted-AHI parameter, incorporating number and severity of obstruction events, has shown good potential, but is calculated using custom-made MATLAB((R)) functions. To allow its clinical use, this study introduces the RemLogic (TM) plug-in. It is tested comparing adjusted-AHI values calculated with the plug-in and MATLAB((R)) with a hundred patients. Furthermore, retrospective follow-up (mean +/- SD = 194.1 +/- 54.0 months) of 1128 working-age men was conducted to evaluate potential of adjusted-AHI to enhance diagnostic of OSA. Adjusted-AHI values were strongly correlated (r = 1.000, p < 0.001) and their average difference (mean +/- SD) was minimal (0.08 +/- 0.19%). Using adjusted-AHI to define OSA severity resulted in a higher hazard ratio of mortality in the severe OSA group and, for the first time, adjusted-AHI was found to explain independently the overall mortality and non-fatal cardiovascular events. Importantly, the present plug-in enables clinical use of adjusted-AHI, enhancing assessment of OSA severity.