An update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine

Abstract

Purpose of reviewThe present review aims to provide an update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine.Recent findingsThe 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/m2 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.SummarySTOP-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.

Evaluation of validity of the STOP-BANG questionnaire in major elective noncardiac surgery

“…0 to 2), intermediate-risk (scores from 3 to 4), and high-risk (scores !5, or scores !2 with any of male sex, BMI >35 kg m À2 or HCO 3 !28 mmol L À1 ). 10 As neck circumference was not captured systematically at one study site, the primary analyses were performed without including neck circumference data in the calculation of STOP-BANG scores.…”

“…8,9 The STOP-BANG questionnaire was developed to screen for OSA and includes eight items (snoring, day time tiredness, observed apnoea, hypertension, BMI >35 kg m À2 , age >50 yr, neck circumference !40 cm, male sex) that generate a summed score. 10 Prior studies have evaluated several different aspects of its validity, 11 both when questionnaire responses were expressed as the STOP-BANG scores themselves or risk strata categorised using recommended definitions (Table 1). 12,13 In general, prior findings with respect to the associations of STOP-BANG scores with comorbidities and outcomes have been inconsistent.…”

“…Similarly, the associations between STOP-BANG scores with postoperative outcomes are inconsistent. 10,12,17,18 While a recent meta-analysis found that high STOP-BANG scores were associated with a nearly four-fold increased odds of cardiorespiratory complications requiring ICU admission and increased hospital length-of-stay, 17 there was significant heterogeneity across samples and outcome definitions. In addition, another large prospective cohort study found no adjusted association between STOP-BANG with mortality up to 1 yr after surgery.…”

Intermittent hypoxia due to sleep apnea syndrome in patients with type 2 diabetes mellitus

“…Однако не существует опросника, который подходил бы всем клиническим субпопуляциям больных. В частности, опросник STOP-BANG зарекомендовал себя как метод предоперационного скрининга СОАС [21] и скрининга в общей популяции при условии коррекции точки разделения [22].…”

Clinical use of the STOP‐BANG questionnaire to determine postoperative risk in veterans

“…[15][16][17][18][19][20] Scores range from 0 to 8: a score of 0 to 2 is low risk for OSA; 3 to 4 is intermediate risk; and 5 to 8 is high risk. 19 Within the VA, there is significant variability nationwide in the management of known and suspected OSA patients undergoing surgery, as well as the postoperative disposition of these patients. 21 Use of the STOP-BANG as one available tool in determining patients at risk for OSA is variable, even within one Veterans Integrated Service Network (V. Malhotra, M.D.…”