Dewi, Brisda Oktavriana and dr. Zamroni Afif,, Sp.S (K), M.Biomed and dr. Catur Arisetianto,, Sp.S (K and dr. Harun Al Rasyid,, MPH (2019) Uji Diagnostik Stop Bang Questionnaire (Sbq) Dan Berlin Questionnaire (Bq) Dibandingkan Dengan Apnea/Hypopnea Index (Ahi) Pada Pasien Obstructive Sleep Apnea (Osa) Di Rs Dr. Saiful Anwar Malang. Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang: Obstructive sleep apnea (OSA) adalah gangguan yang ditandai obstruksi jalan napas atas berulang saat tidur, berakibat pada hypopnea atau apnea (berkurangnya atau berhentinya aliran udara). OSA dapat meningkatkan risiko penyakit kardiovaskular dan kematian. Diagnosis OSA menurut ICSD-3 ditegakkan berdasarkan klinis dan polisomnografi. Namun polisomnografi tidak selalu ada di berbagai pusat kesehatan. Beberapa sistem skoring membantu mengarahkan diagnosis OSA berdasarkan klinis dan komorbid yang berkaitan, diantaranya STOP BANG Questionnaire (SBQ) dan Berlin Questionaire (BQ). Penelitian ini bertujuan menguji dan membandingkan nilai diagnostik antara kedua skoring tersebut dengan parameter nilai Apnea/hypopnea index (AHI) dari polisomnografi sebagai baku emas. Metode: Penelitian cross sectional ini dilaksanakan di laboratorium elektrofisiologi RSU Dr. Saiful Anwar Malang. Subyek total adalah 100 pasien dengan kecurigaan OSA yang telah menjalani pemeriksaan polisomnografi antara tahun 2014 sampai 2019. Dilakukan pengambilan data dasar, hasil penilaian SBQ dan BQ, serta nilai AHI pada hasil polisomnografi pasien, kemudian skor SBQ dan BQ ditabulasi silang dengan AHI melalui tabel 2x2. Nilai diagnostik kedua kuisioner ini dibandingkan. Hasil: Prevalensi OSA di RSSA adalah 54% pada laki-laki dan 24% perempuan, terbanyak pada rentang usia 46-65 tahun (37%) dan BMI overweight (33%). Keluhan dominan subyek OSA adalah mendengkur (49%), dan 35% subyek OSA memiliki riwayat hipertensi. Sensitivitas SBQ dan BQ pada OSA ringan sampai berat (AHI ≥ 5) adalah 82% dan 67%, dan spesifisitasnya 77% dan 64%. Sensitivitas SBQ dan BQ pada OSA sedang sampai berat (AHI ≥ 15) adalah 88% dan 75%, dan spesifisitasnya 58% dan 61%. Pada OSA berat (AHI > 30), sensitivitas SBQ dan BQ adalah 94% dan 81%, dan spesifisitasnya 43% dan 50%. Kesimpulan: Sensitivitas SBQ lebih tinggi dari BQ dalam memprediksi OSA derajat apapun, spesifisitas BQ lebih tinggi dari SBQ untuk OSA sedang-berat. Dalam Penelitian ini, SBQ maupun BQ belum cukup baik untuk identifikasi derajat OSA dikarenakan spesifisitasnya rendah, namun dapat menjadi metode skrining awal yang baik untuk OSA di pusat layanan kesehatan primer dikarenakan sensitivitasnya tinggi.
English Abstract
Background: Obstructive sleep apnea (OSA) is a disorder characterized by repeated upper airway obstruction during asleep, resulting in hypopnea or apnea (reduced or stopped airflow). OSA can increase risk of cardiovascular disease and death. Diagnosing OSA according to ICSD-3 is established on clinical and polysomnographic examination. But polysomnography is not always available in various health centers. Some scoring systems help to predict OSA based on clinical and related comorbidities, including STOP BANG Questionnaire (SBQ) and Berlin Questionaire (BQ). This study aims to test and compare the diagnostic value between both scoring using parameters of Apnea/hypopnea index (AHI) from polysomnography as the gold standard. Method: This cross sectional study was conducted at the electrophysiology laboratory of Dr. Saiful Anwar Malang Hospital. Total subjects were 100 patients suspected of OSA had been examined of polysomnography. Baseline data was taken, as well as the results of SBQ and BQ, also AHI values of polysomnography, then the SBQ and BQ scores were cross-tabulated with AHI through 2x2 table. The results of the diagnostic values of both were compared. Results: The prevalence of OSA in RSSA was 54% in men and 24% in women, most in the age range 46-65 years (37%) and overweight BMI (33%). Dominant complaint of OSA subjects was snoring (49%), and 35% subjects of OSA had a history of hypertension. The sensitivity of SBQ and BQ in mild to severe OSA (AHI ≥ 5) was 82% and 67%, and the specificity was 77% and 64%. The sensitivity of SBQ and BQ in moderate to severe OSA (AHI ≥ 15) was 88% and 75%, and the specificity was 58% and 61%. In severe OSA (AHI > 30), the sensitivity of SBQ and BQ was 94% and 81%, and the specificity is 43% and 50%. Conclusion: Sensitivity of SBQ was higher than BQ to predict any degree of OSA, specificity of BQ was higher than SBQ for moderate-severe OSA. In this study, neither SBQ nor BQ were proper enough to identify mild, moderate, and severe OSA, because of their low specificity value, but might be the good initial screening method for OSA at the setting of primary health care because of their high sensitivity
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| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.209/FK/u/2019/042002035 |
| Uncontrolled Keywords: | Obstructive sleep apnea (OSA), apnea/hypopnea index (AHI), STOP BANG Questionnaire (SBQ), Berlin Questionaire (BQ), Obstructive sleep apnea (OSA), apnea/hypopnea index (AHI), STOP BANG Questionnaire (SBQ), Berlin Questionaire (BQ) |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases > 616.2 Diseases of respiratory system > 616.209 Sleep apnea syndromes |
| Divisions: | Profesi Kedokteran > Spesialis Neurologi, Fakultas Kedokteran |
| Depositing User: | Nur Cholis |
| Date Deposited: | 29 Aug 2022 02:03 |
| Last Modified: | 29 Aug 2022 02:03 |
| URI: | http://repository.ub.ac.id/id/eprint/193666 |
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