The STOP-Bang Equivalent Model and Prediction of Severity of Obstructive Sleep Apnea: Relation to Polysomnographic Measurements of the Apnea/Hypopnea Index

Farney, Robert J.; Walker, Brandon S; Farney, Robert M.; Snow, Greg; Walker, James M.

doi:10.5664/jcsm.1306

Cited by 218 publications

(163 citation statements)

References 33 publications

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“…This is an important finding, given that the vast majority of patients with OSA are not typically diagnosed preoperatively, but can be suspected to have OSA based on patient characteristics, by using the STOPBang screening tool, or by nocturnal oximetry. [26][27][28] Our study has several limitations. Although we objectively measured CPAP adherence, we were unable to obtain adherence data on all the patients.…”

Section: Discussionmentioning

confidence: 99%

CPAP Adherence in Patients with Newly Diagnosed Obstructive Sleep Apnea prior to Elective Surgery

Guralnick

Pant

Minhaj

et al. 2012

Journal of Clinical Sleep Medicine

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Background: Obstructive sleep apnea (OSA) is prevalent in the surgical population, and it has been suggested that preoperative patients should be screened and treated for OSA. However, it remains unclear whether patients diagnosed with OSA in the preoperative period adhere to prescribed CPAP therapy. Objective: Our aim was to objectively quantify CPAP adherence, investigate predictors of poor CPAP adherence, and to establish an optimal CPAP setting in a cohort of presurgical patients diagnosed with OSA as part of the preoperative work-up. Methods: In a retrospective observational study, we collected data on all adult presurgical patients seen by the Anesthesia Perioperative Medicine Clinic (APMC) who screened positive for OSA on the STOP-Bang questionnaire and underwent an in-laboratory diagnostic polysomnogram (PSG) before surgery. CPAP was offered to patients with moderate or severe OSA. Objective CPAP adherence was recorded during the perioperative period. Factors associated with reduced CPAP adherence were delineated. Patient characteristics were compared between those with STOP-Bang scores of 3-4 and those with higher scores (STOP-Bang score ≥ 5). Results: During a 2-year period, 431 patients were referred and 211 patients completed a PSG. CPAP therapy was required in 65% of patients, and the optimal level was 9 ± 2 cm H 2 O. Objective CPAP adherence was available in 75% of patients who received CPAP therapy; median adherence was 2.5 h per night, without any signifi cant difference between the STOP-Bang subgroups. African American race, male gender, and depressive symptomatology were independent predictors of reduced CPAP adherence. Severe OSA was signifi cantly more prevalent in patients with a STOP-Bang score ≥ 5 than those whose score was 3-4 (55.1% versus 34.4%, p = 0.005). However, optimum CPAP pressure levels and adherence to therapy did not differ between the 2 STOP-Bang groups. Conclusions: Adherence to prescribed CPAP therapy during the perioperative period was extremely low. African American race, male gender, and depressive symptoms were independently associated with reduced CPAP usage. Further research is needed to identify and overcome barriers to CPAP acceptance and adherence in the perioperative setting. S C I E N T I F I C I N V E S T I G A T I O N SS ince its initial description more than 40 years ago, OSA has been gaining more interest among anesthesiologists, and there is accumulating evidence that moderate to severe OSA can increase perioperative complications.1-3 Given the important implications of untreated OSA, 4-9 the American Society of Anesthesiologists (ASA) recommends screening presurgical patients for OSA and implementing treatment if signifi cant OSA is present. 10 There is lack of consensus on the most appropriate method of screening, diagnosis, and timing of therapy implementation.11 Although most studies have focused on screening and diagnosis of OSA, less is known about CPAP therapy and adherence during the perioperative period.In this study we aimed to objectively quantif...

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Section: Discussionmentioning

confidence: 99%

CPAP Adherence in Patients with Newly Diagnosed Obstructive Sleep Apnea prior to Elective Surgery

Guralnick

Pant

Minhaj

et al. 2012

Journal of Clinical Sleep Medicine

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“…The STOP-Bang questionnaire has already been successfully applied in preopera- [10]. The stratification of patients based on "STOP BANG" questionnaire score is interesting to indicate the patient with must have an urgent sleep disorder test [11].…”

Section: Discussionmentioning

confidence: 99%

The Stop-Bang Score and Prediction of Severity of Obstructive Sleep Apnea in Surgical Population

Kharrat¹,

Kammoun²

2016

IJRDM

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“…However, a higher ODI (ODI 4 % > 28.5 events per hour) predicted patients at highest risk for postoperative complications in one study [36]. Questionnaires have generally labeled patients as high or low risk for OSA, though the STOP-Bang questionnaire may be useful for differentiating mild from moderate to severe OSA [32,33]. How this correlates with risk for postoperative adverse events is uncertain.…”

Section: Osa Severity Assessment Preoperativelymentioning

confidence: 99%

“…These findings indicate that screen-positive patients are likely to have OSA but that screen-negative patients may still have OSA and thus confound controlled studies. Of all the screening tools available, the STOP-Bang questionnaire is most widely used, likely due to its relative ease of use and additional potential discriminating value for classifying severity of OSA [32,33]. A recent meta-analysis of the STOP-Bang questionnaire has confirmed its accuracy in surgical patients [34].…”

Section: Defining Osa In the Perioperative Settingmentioning

confidence: 99%

Perioperative Complications in Obstructive Sleep Apnea Patients

Auckley

2016

Curr Sleep Medicine Rep

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Obstructive sleep apnea (OSA) is growing in prevalence though it still remains significantly underdiagnosed. Preoperative screening for OSA is taking place in many institutions, with a substantial number of patients being identified as having a high probability for OSA just prior to undergoing surgery. Emerging data increasingly demonstrates that patients with a high probability of having OSA as well as those with a known diagnosis of OSA may be at increased risk for developing complications in the perioperative setting. Postoperative cardiac and pulmonary adverse events appear to occur more frequently in these patients though the impact OSA has on postoperative mortality is controversial. In addition, determining which patients are at greatest risk remains an area of uncertainty. This chapter will review the current state of the knowledge regarding OSA as a risk factor for perioperative complications.

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The STOP-Bang Equivalent Model and Prediction of Severity of Obstructive Sleep Apnea: Relation to Polysomnographic Measurements of the Apnea/Hypopnea Index

Abstract: The STOP-Bang model may be useful to categorize OSA severity, triage patients for diagnostic evaluation or exclude from harm.

Cited by 218 publications

References 33 publications

CPAP Adherence in Patients with Newly Diagnosed Obstructive Sleep Apnea prior to Elective Surgery

CPAP Adherence in Patients with Newly Diagnosed Obstructive Sleep Apnea prior to Elective Surgery

The Stop-Bang Score and Prediction of Severity of Obstructive Sleep Apnea in Surgical Population

Perioperative Complications in Obstructive Sleep Apnea Patients

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