The Value Of Modified Mallampati Score Combined With NoSAS Questionnaire In Screening OSA

Objective To evaluate the value of modified Mallampati score combined with No SAS questionnaire in screening for obstructive sleep apnea(OSA).Methods The patients with snore were recruited from January 2017 to March 2019 in Hefei binhu hospital.All patients were measured for their height,weight,neck circumference and other parameters.No SAS scores,modified Mallampati score and polysomnography(PSG)were performed in these patients.Patients were divided into non OSA group(AHI<5/h)and mild(AHI5-15/h),moderate(AHI16-30/h)and severe OSA group(AHI>30/h)according to the PSG result.The ROC curve was plotted to evaluate the screening value of No SAS questionnaire and modified Mallampati score combined with No SAS questionnaire for OSA.Results A total of 344 patients with suspected OSA were included,including 284 males,60 female.AHI≥5 times/h was used as the diagnostic criteria for obstructive sleep apnea,including 93 cases in the non-osa group with a mean age of 51.42±16.14 years,and 251 cases in the OSA group with a mean age of 45.98±12.80 years.There were 49 mild cases,39 moderate cases and 163 severe cases in OSA group.According to the diagnostic grading criteria of No SAS questionnaire,there were 248 cases in high-risk OSA population and 96 cases in non-high-risk OSA population.According to the modified Mallampati score,110 patients were grade 1 and 2,141 patients were grade 3,and 93 patients were grade 4.The ROC curve and the area under the AUC curve were used to evaluate the screening value of the No SAS questionnaire and the No SAS questionnaire combined with the modified Mallampati score diagnostic model.When the NOSAS questionnaire score≥8 was divided into the standard,the sensitivity and specificity for OSA screening were 0.733 and 0.538 respectively,the area under the ROC curve(AUC)was 0.656,95%CI(0.586,0.727).When the NOSAS questionnaire score ≥9 was divided into the standard,the sensitivity and specificity for OSA screening were 0.701 and 0.624,respectively,and the AUC was 0.656,95%CI(0.586,0.727).When AHI was 5 times/h,15 times/h,and 30 times/h,respectively,the corresponding AUC was 0.656,95%CI(0.586,0.727),0.630,95%CI(0.568,0.691),0.647,95%CI(0.589,0.705).Multiple Logistics regression method was used to make a multi-indicator joint diagnosis model.The sensitivity and specificity of No SAS questionnaire combined with modified Mallampati score for OSA screening were 0.813 and 0.710,respectively,and the AUC was 0.796,95%CI(0.736,0.856).OSA group had sleep disordered breathing,apnea and nocturnal hypoxia,The longest apnea duration,total apnea duration,mean apnea duration,and oxygen decrease index of OSA group were significantly higher than those of snore group(P<0.05),with statistically significant differences.The mean Sa O2 and the lowest Sa O2 in the OSA group were lower than those in the snore group(P<0.05),the difference was statistically significant.Logistic regression analysis showed that No SAS was positively correlated with AHI,oxygen decreasing index,modified Mallampati score,total apnea time,maximum apnea time,and body mass index(BMI)(P<0.05).The No SAS questionnaire score was negatively correlated with the mean and lowest oxygen saturation at night(rs=-0.374,-0.356,p<0.001).The Kruskal-Wallis H test was used to determine the difference of No SAS questionnaire between mild,moderate and severe OSA,indicating that the difference between the three groups was statistically significant(c2=28.16).Conclusion OSA patients had significant nocturnal hypoxia and respiratory disorders,the No SAS questionnaire and modified Mallampati score were correlated with AHI,apnea,hypoxia.As a new screening tool,No SAS questionnaire is simple and convenient,with few subjective items and high accuracy,which has certain screening value for OSA.Modified Mallampati score combined with No SAS questionnaire can significantly improve the sensitivity and specificity of OSA screening,which can be used clinically for OSA screening to facilitate early detection and early intervention of OSA,reduce the occurrence of complications,improve the quality of life of patients,reduce economic costs,and have high application value.