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A simple, inexpensive, and highly accurate scoring system for identifying
surgical patients with obstructive sleep apnea (OSA) has been developed by
a team of Canadian investigators.
OSA is a major risk factor for perioperative adverse events, yet no screening
tool for the condition has been validated in surgical patients, explained
Frances Chung and colleagues from the University of Toronto in Ontario.
The team initially performed a literature review, and established consensus
with a group of anesthesiologists and sleep specialists. The Berlin questionnaire
was examined, to develop the four questions of the STOP questionnaire, which
relate to snoring, tiredness during the daytime, stopped breathing during
sleep, and high blood pressure (STOP).
The four questions were administered alongside the first 10 questions from
the Berlin questionnaire to 254 patients. The STOP questionnaire was then
given to 592 preoperative clinic patients as a pilot study, 55 patients on
two occasions to check the reliability of the questionnaire, and 1875 patients,
who were also invited to undergo an overnight polysomnographic procedure,
as a validation study.
In all, 27.5% of the patients who completed the STOP questionnaire were classified
as being at high risk for OSA. Two hundred and eleven patients underwent
polysomnography, 34 for a pilot study and 177 for validation, at an apnea–hypopnea
index of 20 in the validation group.
Using apnea–hypopnea index cut-off values of 5, greater than 15, and greater
than 30, the sensitivity of the STOP questionnaire for identifying OSA was
65.6%, 74.3%, and 79.5%, respectively. This increased to 83.6%, 92.9%, and
100%, respectively, when body mass index, age, neck circumference, and gender
were incorporated into the STOP questionnaire.
The researchers say in the journal Anesthesiology: “In conclusion, the STOP
questionnaire is a concise and easy-to-use screening tool to identify patients
with a high risk
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