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P137

DIAGNOSTIC PREDICTORS OF OBESITY-HYPOVENTILATION
SYNDROME IN PATIENTS SUSPECTED OF HAVING SLEEP
DISORDERED BREATHING

H. KRICHEN, S. ABID, I. WHADHANE, R. KAMMOUN, S. MSAAD, N. MOUSSA, S. KAMMOUN
FACULTÉ DE MÉDECINE DE SFAX, TUNISIE

BACKGROUND : Obesity is recognized as risk factor for obesity hypoventilation
syndrome (OHS) which is associated with significant morbidity and mortality if not
treated early. However, diagnostic predictors of chronic hypercapnia among obese
patients remains unknown leading to delayed diagnostic and treatment.

OBJECTIVE: To determine diagnostic predictors of OHS among obese patients with
suspected breathing sleep disorders (BSD).
METHODS : Retrospective analysis of data on 110 obese patients with suspected SBD
(mean age 57,35 ±14,15 years; 75,5% females; mean BMI 41,04 ± 7,53).

RESULTS : Among 110 patients included, 46 had OHS while 64 were normocapnic. As
compared with normocapnic obese patients, OHS patients had significantly higher
Charlson comorbidity index (CCI) and mMRC score, significantly increased levels of
leukocytes, CRP, urea, creatinine, hematocrit, uric acid, BNP, bicarbonate and
significantly lower calcium values. They also experienced significantly more severe
sleep respiratory events (apnea hypopnea index (AHI), oximetry values) and
significantly lower values of forced vital capacity (FVC), forced expiratory volume in
the first second (FEV1) and left ventricular systolic ejection fraction (LVSEF). Analysis
of OHS predictors identified significant correlations between pCO2 and FEV1, FVC,
SpO2, apnea hypopnea index (AHI), oxygen desaturation index (ODI), mean and
minimum nocturnal SpO2, sleep time with SpO2 < 90%, pO2, and calculated HCO3
from the arterial blood gaz.
CONCLUSIONS : Serum bicarbonate level and SpO2 may be a simple tool for early
screening of chronic hypoventilation in obese patients."

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