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Clinical use of the STOP ‐ BANG questionnaire to determine postoperative risk in veterans
Author(s) -
Chang Katherine W.,
Steward David L.,
Tabangin Meredith E.,
Altaye Mekibib,
Malhotra Vidhata,
Patil Reena Dhanda
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27295
Subject(s) - medicine , odds ratio , adverse effect , odds , confidence interval , apnea , obstructive sleep apnea , prospective cohort study , body mass index , sleep apnea , anesthesia , logistic regression
Objectives To determine whether STOP‐BANG (snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, gender) scores are associated with immediate postoperative adverse events in veterans undergoing surgery. Methods In this prospective cohort study, veterans presenting to the presurgical clinic at a Veterans Affairs hospital answered the STOP‐BANG questionnaire, which was scored as high risk (5–8), intermediate risk (3–4), and low risk (0–2) for obstructive sleep apnea (OSA), during a 6‐month study period. Immediate postoperative respiratory and cardiovascular adverse events were recorded. Results The patient population included 1,080 veterans. Ninety‐five patients (8.8%) experienced adverse events, of which 74 (6.9%) were respiratory and 21 (1.9%) were cardiovascular in nature. Patients with high‐risk STOP‐BANG scores (5–8) had significantly greater odds of having an adverse event odds ratio (OR) 2.1 (95% confidence interval [CI]: 1.4, 3.3) and hypoxia OR 2.8 (95% CI: 1.7, 4.6) compared to those with low‐ to intermediate‐risk scores (0–4). Among patients with OSA, those with high‐risk scores (5–8) had greater odds of an adverse event OR 3.9 (95% CI: 1.1, 13.9) and hypoxia OR 3.7 (95% CI: 1.1, 13.0) compared to those with low‐ to intermediate‐risk scores (0–4). Patients without a history of OSA with high‐risk scores (5–8) did not have significantly greater odds of an adverse event OR 1.5 (95% CI: 0.82, 2.6) or a hypoxic event OR 1.7 (95% CI: 0.87, 3.4) compared to those with low‐ to intermediate‐risk scores (0–4). Conclusion The STOP‐BANG questionnaire was useful in the veteran population because high‐risk scores were predictive of adverse events, in particular, hypoxia for patients with a previous diagnosis of OSA. In the future, this may direct studies and clinical activities aimed at optimizing safe and effective perioperative practices. Level of Evidence 2b Laryngoscope , 129:259–264, 2019