The role of Sleep Apnea Clinical Score (SACS) as a pretest probability in obstructive sleep apnea

Abstract

A retrospective study was conducted in 198 patients suspected to have OSA at a tertiary centre in Mumbai. The pretest probability for the presence of OSAS was performed using Sleep Apnea Clinical Score (SACS).SACS score was calculated as: Snoring 3 points, Apnea 3 points, Neck Circumference in centimeters, Systemic Hypertension 4 points. Risk stratification of SACS score was done as < 43 low risk, 43-48 moderate risk, >48 high risk. A diagnosis of OSAS was done by using the criteria laid down by American Academy of Sleep Medicine (AASM). Polysomnography (PSG) showing AHI of 5 or more was considered as diagnostic of OSA. A correlation was established between SACS and OSA using Chi square test. 29/51(56.8%) did not have OSA when their SACS score was low. 53/81(65.43%) had OSA when their SACS score was moderate. With high SACS score 56/66 (84.84%) showed presence of OSA. Overall moderate to high SACS score was able to predict OSA in 109/147 (74.15%). The correlation between SACS score and presence of OSA was highly significant (p value = 0.0000137).