title: An update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine.
abstract: OBJECTIVE
  The present review aims to provide an update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine.
  
  
  RESULTS
  The STOP-Bang questionnaire was originally validated as a screening tool to identify surgical patients who are at high-risk of obstructive sleep apnea (OSA). A recent meta-analysis confirmed that STOP-Bang is validated for use in the sleep clinic, surgical, and general population. Patients with a STOP-Bang score of 0--2 can be classified as low-risk for moderate-to-severe OSA. Those with a score of 5--8 can be classified as high-risk for moderate-to-severe OSA. In patients with a score of 3 or 4, a specific combination of a STOP score at least 2 + BMI more than 35 kg/m or STOP score at least 2 + male or STOP score at least 2 + neck circumference more than 40 cm indicates higher risk for moderate-to-severe OSA. Further, patients with a STOP-Bang score at least 3 can be classified as high risk for moderate-to-severe OSA if the serum HCO3 at least 28 mmol/l. STOP-Bang can be used as a novel tool for perioperative risk stratification because it easily identifies patients who are at increased risk of perioperative complications.
  
  
  CONCLUSIONS
  STOP-Bang at least 3 was recommended previously to identify the suspected or undiagnosed OSA. To reduce the false positive cases and to improve its specificity, a stepwise stratification is recommended to identify the patients at high risk of moderate-to-severe OSA. Because of its practical application, STOP-Bang is a useful screening tool for patients with suspected or undiagnosed OSA.
authors.affiliation: aDepartment of Anesthesiology and Perioperative Medicine, University Hospital, Victoria Hospital and St. Joseph's Hospital, London Health Sciences and St. Joseph's Healthcare, Western University, London bDepartment of Anesthesiology cDepartment of Anesthesia, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Nagappa
authors.forename: Jean
authors.initials: J
authors.lastname: Wong
authors.forename: Mandeep
authors.initials: M
authors.lastname: Singh
authors.forename: David T
authors.initials: DT
authors.lastname: Wong
authors.forename: Frances
authors.initials: F
authors.lastname: Chung
mesh_terms: D000776:Anesthesiology / Q000379:methods*; D001639:Bicarbonates; D006801:Humans; D019990:Perioperative Care / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D011795:Surveys and Questionnaires / Q000706:statistics & numerical data*; D013997:Time Factors; D014218:Triage / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D001639:Bicarbonates