Poster Presentations: Wednesday, October 26, 2011 |

Racial Differences in the Predictive Value of Mallampati Score for Obstructive Sleep Apnea FREE TO VIEW

Omar Albustami, MD; Md. Islam, MD; Khawaja Rahman, MD; Sunil Sharma, MD
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East Carolina University, Brody School of Medicine, Greenville, NC

Chest. 2011;140(4_MeetingAbstracts):815A. doi:10.1378/chest.1109359
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PURPOSE: Obstructive sleep apnea (OSA) affects 9% of females & 25% of males. Prevalence of OSA is even higher in obese and elderly patients. OSA is associated with serious long term health consequences including cardiovascular disease, hypertension, and stroke and a reduced quality of life. Mallampati score has been reported to be significantly associated with OSA. However, its clinical usefulness has not been addressed specifically in African American patients. Our purpose is to determine if race affects the clinical usefulness of the Mallampati score in patients with OSA.

METHODS: The medical charts of 450 patients, who had overnight Polysomnography, were reviewed retrospectively. Three hundred and forty seven patients (n= 347, 77.1%) had Apnea Hypopnea Index (AHI) ≥ 5 and were considered having OSA and one hundred and three patients (n= 103, 22.9%) did not have OSA (AHI < 5). Chi square test was used for categorical data analysis and Student's t-test was used for numerical data analysis. P-value <0.05 was considered significant.

RESULTS: Compared to patients who did not have OSA, patients with OSA were more likely to have Mallampati score III/IV in the whole group and African Americans (p <0.001 for both), but not in Caucasians (p =0.077). Mallampati score I/II negative predictive value (NPV) was 92.4% for the whole group and 96.1% for African Americans. Mallampati score III/IV positive predictive value (PPV) was 80.8% for the whole group and 81.3% for African Americans, and sensitivity was 92.8% for the whole group and 95.9% for the African Americans.

CONCLUSIONS: High Mallampati score (III/IV) has significant correlation with OSA in African Americans but not in Caucasians. High Mallampati score has high PPV and sensitivity while low Mallampati (I/II) score has high NPV.

CLINICAL IMPLICATIONS: Mallampati score should be a part of the physical examination of African American patients with suspected SDB that can be applied easily and quickly in the clinical setting.

DISCLOSURE: The following authors have nothing to disclose: Omar Albustami, Md. Islam, Khawaja Rahman, Sunil Sharma

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