The STOP-BANG questionnaire and the risk of perioperative respiratory complications in urgent surgery patients: A prospective, observational study.
BACKGROUND
The STOP-BANG (SB) questionnaire, a tool originally proposed for identifying patients at risk of obstructive sleep apnoea, may also identify patients at increased risk of perioperative complications (when>3). Perioperative complications, including respiratory ones, are more frequent in emergency surgery. This study aimed at evaluating whether the SB is predictive of perioperative respiratory complications in urgent surgery.


METHODS
Consecutive adult patients admitted for an urgent surgery under general anaesthesia were included. The STOP-BANG questionnaire was completed before anaesthesia. Perioperative respiratory complications were prospectively recorded during surgery and in the postoperative care unit (PACU).


RESULTS
One hundred and eighty-nine patients were included (women 46%, median age 60 [43-78] years old) of which 104 (55%) were SB+. Diabetes mellitus and arrhythmia were more frequent in the SB+ patients than in SB-. The ASA class was higher in SB+ patients compared with SB-, but type and duration of surgery were statistically similar. The incidence of respiratory complications was higher in SB+ patients both during surgery (21% versus 6%, P<0.002) and in the PACU (57% versus 34%, P=0.0015). Furthermore, SB+ patients had a prolonged length of hospital stay (6 [3-12] versus 4 [2-7] days, P=0.0002). In a multivariate analysis, the STOP-BANG score was independently associated with respiratory complications (OR [CI 95%]=1.44 [1.03-2.03], P=0.03).


CONCLUSIONS
An elevated STOP-BANG score (≥ 3) is associated with an increased risk of perioperative respiratory complications and with prolonged length of stay in urgent surgery patients.
Département d'anesthésie-réanimation, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France.
Nicolas
N
Chudeau
Département d'anesthésie-réanimation, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France.
Tommy
T
Raveau
Département d'anesthésie-réanimation, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France.
Laurence
L
Carlier
Département d'anesthésie-réanimation, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France.
Damien
D
Leblanc
Département d'anesthésie-réanimation, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France.
Guillaume
G
Bouhours
Service de pneumologie, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France.
Frédéric
F
Gagnadoux
Département d'anesthésie-réanimation, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France.
Emmanuel
E
Rineau
Département d'anesthésie-réanimation, LUNAM université, université d'Angers, CHU d'Angers, 49933 Angers, France. Electronic address: sigismond@lasocki.com.
Sigismond
S
Lasocki
D000328:Adult; D000368:Aged; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012120:Respiration Disorders / Q000453:epidemiology*; D018570:Risk Assessment / Q000379:methods; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
Difficult intubation; Obstructive sleep apnoea; Postoperative complications; STOP-BANG; Urgent surgery