| Abstract | Cilj istraživanja: Cilj ove presječne studije je dokazati promjene kvalitete spavanja u populaciji elektivnih kardiokirurških bolesnika korištenjem Pittsburghova upitnika (PSQI) u prijeoperacijskom periodu. Kao dodatne mjere ishoda pratili su se povećani rizik za opstrukcijsku apneju tijekom spavanja (OSA) korištenjem STOP i STOP BANG testova, te prekomjerna dnevna pospanost pomoću Epworthove ljestvice pospanosti (ESS).
Bolesnici i postupci: Istraživanje je uključivalo 59 ispitanika. U ispitivanu skupinu uključeni su bolesnici (n=29) KBC-a Split koji su pristupili prijeoperacijskoj anesteziološkoj obradi u sklopu kardiokirurškog zahvata. Kontrolnu skupinu činilo je 30 ispitanika nasumično odabranih, a bez kardiokirurške dijagnoze. Ispitanici su testirani putem PSQI upitnika (pozitivan ako je zbroj ≥ 6), STOP testa (pozitivan ≥ 2), STOP-BANG testa (pozitivan ≥ 3), a prekomjerna dnevna pospanost ocjenjivana je pomoću ESS (pozitivan ≥7). Rezultati su statistički analizirani programom Statistica 8.0 (Stat-Soft, Inc., Tulsa, SAD). Usporedba kontinuiranih varijabli vršena je putem Studentova t-testa. Za usporedbu podataka na ordinalnoj ili nominalnoj skali korišten je χ2-test. P< 0,05 smatran je statistički značajnim.
Rezultati: Demografska i antropometrijska obilježja bolesnika (spol, dob, BMI, opseg vrata) nisu pokazala statistički značajnu razliku među skupinama. Uporabom PSQI nije pronađena prijeoperacijska lošija kvaliteta spavanja u elektivnih kardiokirurških bolesnika u odnosu na kontrolnu skupinu (6,17 2,77 vs 5,27 2,57, P=0,198). Isto tako, nije nađena razlika u omjeru pozitivnih i negativnih bolesnika po PSQI (2 = 2,038, P= 0,153). Statističkom obradom svih 7 komponenti PSQI upitnika nije nađena statistički značajna razlika među skupinama. Testiranje STOP i STOP BANG upitnikom nije našlo razlike među ispitivanim skupinama (STOP 1,5 1,1 vs 1,2 1,3, P=0,32; STOP-BANG 4,0 1,8 vs 3,5 1,7, P=0,22). Nije nađena razlika u broju STOP i STOP BANG pozitivnih bolesnika po skupinama (STOP 41,4% vs 36,7%, P=0,92; STOP BANG 75,9% vs 75,3%, P=0,82). Statističkom analizom ESS kod kardiokirurških bolesnika (4,0 2,9) i kontrolne skupine (5,6 3,3) dokazana je veća dnevna pospanost kod ispitanika kontrolne skupine s graničnom statistički značajnom vrijednosti (P=0,052).
Zaključak: U ovom ispitivanju korištenjem nekoliko upitnika (PSQI, STOP, STOP-BANG, ESS) nije dokazana lošija prijeoperacijska kvaliteta spavanja u elektivnih kardiokirurških bolesnika, kao ni povećan rizik za OSA u odnosu na zdravu populaciju. Osim toga, istraživanje je pokazalo izraženiju prekomjernu dnevnu pospanost u kontrolnoj skupini u odnosu na kardiokirurške bolesnike. |
| Abstract (english) | Objective: The aim of this cross-sectional study was to demonstrate changes in the quality of sleep in the population of elective heart surgery patients by using the Pittsburgh questionnaire (PSQI) in the preoperative period. Additional outcome measures were an increased risk of obstructive sleep apnea (OSA) evaluated by STOP and STOP BANG questionnaires, as well as the excessive daytime sleepiness (EDS) evaluated by the Epworth sleepiness scale (ESS).
Patients and Methods: The study included 59 patients. The experimental group included patients (n = 29) of the University Hospital Split who underwent the preanesthesia evaluation before elective cardiac surgery. The control group consisted of 30 randomly selected subjects, not having cardiac diagnosis. All subjects were tested by PSQI questionnaire (positive if ≥ 6 points), STOP (positive if ≥ 2 criteria positive), and STOP-BANG questionnaire (positive if ≥ 3 criteria positive), and EDS was assessed using the ESS (positive if ≥7 points). The results were statistically analyzed using Statistica 8.0 (Stat-Soft, Inc., Tulsa, USA). Comparison of continuous variables was performed using Student’s t-test. χ2 -test was used for comparison of data on a nominal or an ordinal scale. P<0.05 was considered statistically significant.
Results: There was no statistical difference in demographic and anthropometric data of the patients (sex, age, BMI, neck circumference). Using preoperative PSQI, there was no significant difference in sleep quality between elective cardiac patients and the control group (6.17 2.77 vs 5.27 2.57, P=0.198). Likewise, there was no difference in the proportion of positive and negative patients according to PSQI (2 = 2.038, P = 0.153). Statistical analysis of all 7 components of PSQI questionnaire didn't find any significant difference between groups. There was no statistical significant difference in results of STOP and STOP BANG questionnaires between 2 groups (STOP 1.5 1.1 vs 1.2 1.3, P=0.32; STOP-BANG4.0 1.8 vs 3.5 1.7, P=0.22). There was no difference in the number of STOP and STOP BANG positive patients per group (STOP 41.4% vs 36.7%, P = 0.92; STOP BANG 75.9% vs 75.3%, P = 0.82). ESS of patients in the control group demonstrated greater daytime sleepiness (5.6 ± 3.3) in comparison to the heart surgery patients (4.0 ± 2.9) with borderline statistically significant values (P = 0.052).
Conclusion: In this study, by using several preoperative questionnaires on OSA (PSQI, STOP, STOP-BANG, ESS), there were no significant differences in preoperative quality of sleep in elective cardiac patients, as well as increased risk for OSA compared to the healthy population. In addition, this research has shown a more excessive daytime sleepiness in the control group compared to cardiac patients. |
