Using the STOP-BANG questionnaire to predict hypoxaemia in patients recovering from noncardiac surgery: a prospective cohort analysis.
BACKGROUND
The STOP-BANG questionnaire is a validated, eight-point dichotomized scale used to screen preoperative patients for obstructive sleep apnoea. Sleep apnoea causes hypoxaemia, and nocturnal oxygen desaturation is diagnostic in these patients. We tested the hypothesis that STOP-BANG score is associated with hypoxaemia after noncardiac surgery.


METHODS
This analysis was a sub-study of VISION, a prospective cohort study of perioperative cardiovascular events. With institutional review board approval, we included 630 patients in the final analysis. We assessed the association between the STOP-BANG score and postoperative hypoxaemia, defined as integrated area under the curve of [Formula: see text] saturation of 90% per h using median quantile regression. Secondarily, we selected a subset of STOP-BANG questions that best predicts postoperative hypoxaemia using 'Least Absolute Shrinkage and Selection Operator' method, and then assessed the association between the new score based on the selected questions and the primary outcome using quantile regression.


RESULTS
The median [q1, q3] area under [Formula: see text] of 90% per h was 0.09 [0.02, 0.39] %-h. The STOP-BANG score was not associated with hypoxaemia, with a multivariable slope coefficient of 0.002 (95% CI: -0.01, 0.01) %-h for a unit increase in the score (P=0.76). Secondarily, no association was found between the new score based on the two retained STOP-BANG questions, treatment for hypertension and neck circumference >40 cm, and the primary outcome with a multivariable slope coefficient of 0.03 (98.3% CI: -0.01, 0.06) %-h/score (P=0.07).


CONCLUSIONS
The STOP-BANG score does not predict hypoxaemia in adults recovering from noncardiac surgery.


BACKGROUND
NCT00512109.
Center for Critical Care Department of Outcomes Research Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA khannaa@ccf.org.
A K
AK
Khanna
Department of Outcomes Research.
D I
DI
Sessler
Department of Outcomes Research Anesthesiology and Perioperative Medicine, Georgia Regents University, Augusta, Georgia, USA.
Z
Z
Sun
Department of Outcomes Research.
A J
AJ
Naylor
Department of Outcomes Research Department of Quantitative Health Sciences, Cleveland, Ohio, USA.
J
J
You
Department of Outcomes Research Department of Psychiatry, Rush University, Chicago, IL, USA.
B D
BD
Hesler
Department of Outcomes Research Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
A
A
Kurz
Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada Department of Clinical Epidemiology Department of Biostatistics Department of Medicine, McMaster University, Hamilton, Canada.
P J
PJ
Devereaux
Department of Outcomes Research Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
L
L
Saager
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis*; D011795:Surveys and Questionnaires
anaesthesia; apnoea; care; hypoxaemia; obstructive sleep; oximetry; postoperative; pulse