High STOP-BANG questionnaire scores predict intraoperative and early postoperative adverse events.
BACKGROUND
Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder associated with multisystemic organ involvement. The STOP-BANG questionnaire is a concise, validated questionnaire that is used to screen for OSA. This study aimed to establish the use of the STOP-BANG questionnaire for perioperative patient risk stratification.


METHODS
In this retrospective cohort study, we extracted the demographic, medical and perioperative outcome data of all patients who underwent elective surgery, excluding ophthalmic surgeries, from January to December 2011. Multivariate regression analysis was used to predict independent risk factors for intraoperative and early postoperative adverse events.


RESULTS
Of the 5,432 patients analysed, 7.4% had unexpected intraoperative and early postoperative adverse events. We found that the risk of unexpected intraoperative and early postoperative adverse events was greater in patients with STOP-BANG scores ≥ 3 compared to those with a STOP-BANG score of 0 (score 3: odds ratio [OR] 3.6, 95% confidence interval [CI] 2.1-6.3, p < 0.001; score 4: OR 3.4, 95% CI 1.8-6.5, p < 0.001; score 5: OR 6.4, 95% CI 2.7-15.0, p < 0.001; score ≥ 6: OR 5.6, 95% CI 2.1-15.4, p < 0.001). Patients with STOP-BANG scores ≥ 5 had a fivefold increased risk of unexpected intraoperative and early postoperative adverse events, while patients with STOP-BANG scores ≥ 3 had a 'one in four' chance of having an adverse event. Other independent predictors included older age (p < 0.001), American Society of Anesthesiologists class ≥ 2 (p < 0.003) and uncontrolled hypertension (p = 0.028).


CONCLUSIONS
STOP-BANG score may be used as a preoperative risk stratification tool to predict the risk of intraoperative and early postoperative adverse events.
Edwin
E
Seet
Maureen
M
Chua
Department of Anaesthesia, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828. liaw.chen.mei@alexandrahealth.com.sg.
Chen Mei
CM
Liaw
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires