Predictive factors for CPAP failure in obstructive sleep apnea patients.

Content Provider	Europe PMC
Author	Goyal, Abhishek Joshi, Ankur Mitra, Arun Khurana, Alkesh Chaudhary, Poonam
Copyright Year	2021
Abstract	Objectives:Some patients with obstructive sleep apnea (OSA) do not respond to Continuous Positive Airway Pressure (CPAP) and for these patients, Bi-level PAP is the next level modality. This study by a theory driven hierarchical approach, tries to identify the predictors for CPAP failure among OSA patients.Methodology:The potential predictors for the model were identified from a theoretical framework rooted in clinical examination, laboratory parameters, and polysomnographic variables pertaining to OSA patients. All patients of OSA who underwent manual titration with CPAP or Bi-level PAP (in case of CPAP Failure) between June 2015 and October 2017 were included in model building. This study compared five competitive models blocks deliberated by increasing order of diagnostic complexity and availability of resources. The fitting of the model was determined by both internal and external validation.Results:Among the five competitive models, the selected model has the significant deviance reduction (−2LL = 121.99, X2 = 25.55, P < 0.0001) from the baseline model (−2LL = 217.356). This logistic regression model consists of the following binary predictors – Age >60 years (odds ratio [OR] = 3.23 [1.27–8.23]), body mass index >35 Kg/m2 (OR = 4.25 [1.78–10.13]), forced expiratory volume <60% (OR = 7.33 [2.83–18.72]), apnea-hypopnea index >75 (OR = 4.31 [1.61–11.56]) and T90 > 30% (OR = 6.67 [2.57–17.36]).Conclusion:These five factors (acronym as BIPAP) may aid to the clinical decision-making by predicting failure of CPAP and therefore may assist in more vigilant clinical care.
ISSN	09702113
Journal	Lung India : Official Organ of Indian Chest Society
Volume Number	38
PubMed Central reference number	PMC8614613
Issue Number	6
PubMed reference number	34747736
e-ISSN	0974598X
DOI	10.4103/lungindia.lungindia_867_20
Language	English
Publisher	Wolters Kluwer - Medknow
Publisher Date	2021-11-01
Publisher Place	India
Access Restriction	Open
Rights License	This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Copyright: © 2021 Indian Chest Society
Subject Keyword	Apneas Obstructive Sleep CPAP Ventilation BiPAP Bilevel Positive Airway Pressure CPAP failure
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine