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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar la situaci&#243;n del diagn&#243;stico y tratamiento en el s&#237;ndrome de apneas-hipopneas obstructivas durante el sue&#241;o &#40;SAHS&#41; y conocer algunas caracter&#237;sticas de los pacientes tratados con presi&#243;n nasal positiva continua en la v&#237;a a&#233;rea &#40;n-CPAP&#41; en nuestra comunidad&#46;</p> <span class="elsevierStyleSectionTitle">Metodolog&#237;a</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; en el estudio a todos los pacientes que en julio de 2000 recib&#237;an tratamiento con n-CPAP a cargo del Servicio Navarro de Salud&#46; Una enfermera realiz&#243; una visita a cada paciente en la que rellenaba un formulario con datos epidemiol&#243;gicos&#44; antropom&#233;tricos y cl&#237;nicos&#59; posteriormente llevaba a cabo las siguientes exploraciones&#58; medici&#243;n del CO en el aire espirado&#44; determinaci&#243;n de la presi&#243;n de n-CPAP utilizada y lectura del contador horario de la n-CPAP&#46; Entre uno y 2 meses despu&#233;s&#44; y sin previo aviso&#44; se pon&#237;a de nuevo en contacto con el usuario y se proced&#237;a a una segunda visita en la que realizaba una segunda determinaci&#243;n de CO en el aire espirado y nueva lectura del contador&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La tasa de prevalencia de tratamientos con n-CPAP en nuestra comunidad fue de 125 por 100&#46;000 habitantes&#44; y se comprob&#243; un progresivo incremento de las prescripciones anuales&#46; Se visit&#243; en el domicilio a 535 pacientes &#40;el 80&#44;7&#37; del total&#41;&#46; El 83&#44;5&#37; de las indicaciones fueron realizadas por neum&#243;logos&#59; la media de horas&#47;d&#237;a reales de utilizaci&#243;n de n-CPAP fue de 6&#44;1 y existi&#243; una correlaci&#243;n estad&#237;sticamente significativa entre las horas de uso de n-CPAP declaradas y las reales&#59; el &#237;ndice de apneas-hipopneas &#40;IAH&#41; medio fue de 51&#44;5 y este &#237;ndice no se determin&#243; en el 4&#44;2&#37; de los casos&#46; Un 83&#44;7&#37; de los pacientes declaraban tener una tolerancia del tratamiento muy buena o buena y el 24&#44;8&#37; llevaba m&#225;s de 4 a&#241;os con esta terapia&#46; La enfermedad asociada con el SAHS m&#225;s frecuente fue la obesidad&#44; presente en el 73&#44;4&#37; de las personas&#44; seguida de la hipertensi&#243;n arterial en el 40&#37;&#59; 299 enfermos &#40;55&#44;8&#37;&#41; padec&#237;an dos o m&#225;s enfermedades asociadas y 54 &#40;9&#44;7&#37;&#41; no ten&#237;an ninguna&#46; El 45&#44;9&#37; de los casos dispon&#237;a de polisomnograf&#237;a convencional como m&#233;todo diagn&#243;stico y un 49&#44;7&#37; de poligraf&#237;a respiratoria&#59; en el 19&#44;4&#37; la nivelaci&#243;n de la presi&#243;n se realiz&#243; con polisomnograf&#237;a y el 32&#44;1&#37; no dispon&#237;a de ning&#250;n estudio para este fin&#46; Un 50&#44;8&#37; de las personas refer&#237;an presentar alg&#250;n efecto secundario al tratamiento&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Elevada tasa de prevalencia de tratamientos con n-CPAP en Navarra y progresivo incremento de prescripciones&#46; Buena tolerancia y cumplimiento de la terapia por parte de los pacientes&#46; Disponibilidad en la mayor&#237;a de los casos de polisomnograf&#237;a o poligraf&#237;a respiratoria como m&#233;todos diagn&#243;sticos de SAHS y alto porcentaje de titulaciones de n-CPAP sin haberse realizado los estudios recomendados&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome &#40;OSAHS&#41; in Navarra &#40;Spain&#41; and to know the characteristics of patients treated with nasal continuous positive airway pressure &#40;n-CPAP&#41; in our community&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">All patients receiving nasal n-CPAP from the public health service of Navarra in July 2000 were enrolled&#46; A nurse visited each patient and filled in a form with epide-miological data&#44; and patient and clinical characteristics&#46; The nurse then measured CO in expired air and the n-CPAP pressure used and recorded the hour counter reading on the n-CPAP device&#46; Between one and two months later and without prior warning&#44; the patient was once again contacted and a second visit was made&#46; The counter was read again and expired CO was measured&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The prevalence of treatment with n-CPAP in Navarra was 125&#47;100&#44;000 inhabitants&#44; and a gradual increase in annual prescriptions was observed&#46; Home visits were made to 535 patients &#40;80&#46;7&#37; of the total&#41;&#46; Pneumologists wrote 83&#46;5&#37; of the prescriptions&#46; n-CPAP was used a mean 6&#46;1 hours&#47;day&#44; and the numbers of declared and real hours of use were statistically correlated&#46; The mean apnea-hypopnea index was 51&#46;5&#44; although results were not available for 4&#46;2&#37; of the patients&#46; The treatment was well tolerated according to 83&#46;7&#37; of the patients and 24&#46;8&#37; had been following it for over four years&#46; The pathology most often associated with OSAHS was obesity &#40;73&#46;4&#37; of the patients&#41;&#44; followed by high blood pressure &#40;40&#37;&#41;&#59; 299 patients &#40;55&#46;8&#37;&#41; had two or more associated diseases and 54 &#40;9&#46;7&#37;&#41; had none&#46; Conventional polysomnography was the diagnostic method used in 45&#46;9&#37; of the cases&#44; and respiratory polygraphs were available for 49&#46;7&#37;&#46; Pressure was adjusted with the aid of polysomnography for 19&#46;4&#37; patients&#44; whereas 32&#46;1&#37; had undergone no testing&#46; Side effects of treatment were reported by 50&#46;8&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">a&#41; The prevalence of n-CPAP treatment in Navarra is high and prescriptions are increasing&#59; b&#41; patient tolerance of and compliance with therapy are good&#44; c&#41; poly-somnographs or respiratory polygraphs are available for diagnosis of OSAHS in most cases but the n-CPAP pressure level is adjusted without the recommended studies for many patients&#46;</p>"
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Vol. 38. Issue 12.
Pages 554-560 (December 2002)
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Vol. 38. Issue 12.
Pages 554-560 (December 2002)
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Situación en Navarra del diagnóstico y tratamiento en el síndrome de apneas-hipopneas obstructivas durante el sueño
Diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome: the situation in Navarra (Spain)
Visits
6334
J. Hueto
Corresponding author
jhuetope@cfnavarra.es

Correspondencia: Sección de Neumología. Hospital Virgen del Camino. Irunlarrea, s/n. 31008 Pamplona (Navarra). España
, J. Boldú, P. Cebollero, J.A. Cascante, J. Abu-Shams, V.M. Eguía, N. Esandi
Sección de Neumología. Hospital Virgen del Camino. Pamplona (Navarra). España
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Objetivo

Evaluar la situación del diagnóstico y tratamiento en el síndrome de apneas-hipopneas obstructivas durante el sueño (SAHS) y conocer algunas características de los pacientes tratados con presión nasal positiva continua en la vía aérea (n-CPAP) en nuestra comunidad.

Metodología

Se incluyó en el estudio a todos los pacientes que en julio de 2000 recibían tratamiento con n-CPAP a cargo del Servicio Navarro de Salud. Una enfermera realizó una visita a cada paciente en la que rellenaba un formulario con datos epidemiológicos, antropométricos y clínicos; posteriormente llevaba a cabo las siguientes exploraciones: medición del CO en el aire espirado, determinación de la presión de n-CPAP utilizada y lectura del contador horario de la n-CPAP. Entre uno y 2 meses después, y sin previo aviso, se ponía de nuevo en contacto con el usuario y se procedía a una segunda visita en la que realizaba una segunda determinación de CO en el aire espirado y nueva lectura del contador.

Resultados

La tasa de prevalencia de tratamientos con n-CPAP en nuestra comunidad fue de 125 por 100.000 habitantes, y se comprobó un progresivo incremento de las prescripciones anuales. Se visitó en el domicilio a 535 pacientes (el 80,7% del total). El 83,5% de las indicaciones fueron realizadas por neumólogos; la media de horas/día reales de utilización de n-CPAP fue de 6,1 y existió una correlación estadísticamente significativa entre las horas de uso de n-CPAP declaradas y las reales; el índice de apneas-hipopneas (IAH) medio fue de 51,5 y este índice no se determinó en el 4,2% de los casos. Un 83,7% de los pacientes declaraban tener una tolerancia del tratamiento muy buena o buena y el 24,8% llevaba más de 4 años con esta terapia. La enfermedad asociada con el SAHS más frecuente fue la obesidad, presente en el 73,4% de las personas, seguida de la hipertensión arterial en el 40%; 299 enfermos (55,8%) padecían dos o más enfermedades asociadas y 54 (9,7%) no tenían ninguna. El 45,9% de los casos disponía de polisomnografía convencional como método diagnóstico y un 49,7% de poligrafía respiratoria; en el 19,4% la nivelación de la presión se realizó con polisomnografía y el 32,1% no disponía de ningún estudio para este fin. Un 50,8% de las personas referían presentar algún efecto secundario al tratamiento.

Conclusiones

Elevada tasa de prevalencia de tratamientos con n-CPAP en Navarra y progresivo incremento de prescripciones. Buena tolerancia y cumplimiento de la terapia por parte de los pacientes. Disponibilidad en la mayoría de los casos de polisomnografía o poligrafía respiratoria como métodos diagnósticos de SAHS y alto porcentaje de titulaciones de n-CPAP sin haberse realizado los estudios recomendados.

Palabras clave:
Síndrome de apneas-hipopneas durante el sueño
Diagnóstico
Presión positiva continua sobre la vía aérea
Cumplimiento
Efectos secundarios
Objective

To assess the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) in Navarra (Spain) and to know the characteristics of patients treated with nasal continuous positive airway pressure (n-CPAP) in our community.

Method

All patients receiving nasal n-CPAP from the public health service of Navarra in July 2000 were enrolled. A nurse visited each patient and filled in a form with epide-miological data, and patient and clinical characteristics. The nurse then measured CO in expired air and the n-CPAP pressure used and recorded the hour counter reading on the n-CPAP device. Between one and two months later and without prior warning, the patient was once again contacted and a second visit was made. The counter was read again and expired CO was measured.

Results

The prevalence of treatment with n-CPAP in Navarra was 125/100,000 inhabitants, and a gradual increase in annual prescriptions was observed. Home visits were made to 535 patients (80.7% of the total). Pneumologists wrote 83.5% of the prescriptions. n-CPAP was used a mean 6.1 hours/day, and the numbers of declared and real hours of use were statistically correlated. The mean apnea-hypopnea index was 51.5, although results were not available for 4.2% of the patients. The treatment was well tolerated according to 83.7% of the patients and 24.8% had been following it for over four years. The pathology most often associated with OSAHS was obesity (73.4% of the patients), followed by high blood pressure (40%); 299 patients (55.8%) had two or more associated diseases and 54 (9.7%) had none. Conventional polysomnography was the diagnostic method used in 45.9% of the cases, and respiratory polygraphs were available for 49.7%. Pressure was adjusted with the aid of polysomnography for 19.4% patients, whereas 32.1% had undergone no testing. Side effects of treatment were reported by 50.8%.

Conclusions

a) The prevalence of n-CPAP treatment in Navarra is high and prescriptions are increasing; b) patient tolerance of and compliance with therapy are good, c) poly-somnographs or respiratory polygraphs are available for diagnosis of OSAHS in most cases but the n-CPAP pressure level is adjusted without the recommended studies for many patients.

Keywords:
Sleep apnea-hypopnea syndrome
Diagnosis
Continuous positive airway pressure
Compliance
Side effects
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Copyright © 2002. Sociedad Española de Neumología y Cirugía Torácica
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