Sleep Disorders |

Does the STOP-Bang Questionnaire Predict Severity of Obstructive Sleep Apnea in Patients Undergoing Bariatric Surgery? FREE TO VIEW

Kristin Fless; Prakash Paragi; Ravali Tarigopula; Conor Wentworth; Raj Patel
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Pulmonary Critical Care, Saint Barnabas Medical Center, Livingston, NJ

Chest. 2014;146(4_MeetingAbstracts):935A. doi:10.1378/chest.1988864
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SESSION TITLE: Sleep Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: It is estimated that 65 % of patients undergoing bariatric surgery have obstructive sleep apnea (OSA). Various screening questionnaires are described to predict the presence of OSA in surgical patients prior to surgery. These questionnaires are long and usually administered immediately peri-operatively where the opportunity to test and treat for OSA is impractical. Currently there is no universal recommendation to screen or test patients prior to bariatric surgery. A simple 8 question screening (STOP-Bang) has been shown to be as good at predicting OSA as longer questionnaires. We assessed the utility of STOP-Bang in predicting the severity of OSA in the bariatric surgery population.

METHODS: We performed a retrospective analysis of 27 patients who had weight loss surgery by a single surgeon in our center and polysomnographic testing for OSA between January 2011- September 2012. STOP-Bang information was collected from chart review. STOP-Bang consists of eight yes or no questions: snoring, tiredness, observed apnea, hypertension, BMI>35kg/m2, age>50, neck circumference>40cm. Each postive response is scored as 1 point. STOP-Bang information was complete in 15 out of 27 charts. Incomplete charts were excluded

RESULTS: 80% (n=12) patients had confirmed OSA. The average Apnea hypopnea index (AHI) was 31.5 (SD 33.7). The average STOP-Bang score was 5 (SD 1.4). STOP-Bang scores ranged from 3 (n=3), 4(n=2), 5( n=4), 6 (n=5) and 8 (1). No patient had a STOP-Bang score of 2 or less. No correlation was seen between AHI and STOP-Bang score (r2=0.034).

CONCLUSIONS: Increasing STOP-Bang score did not correlate with the increased AHI and severity of OSA in this bariatric surgery population. Previous studies have confirmed that STOP-Bang score of greater than 3 correlates with AHI>5 with 83% sensitivity. Limitations of this study are its small sample size and its retrospective nature (all patients included a priori were sent for polysomnography; patients felt to be low risk for OSA by history and clinical exam were not included) and therefore sensitivity for OSA could not be calculated.

CLINICAL IMPLICATIONS: Although this retrospective study did not show a correlation between STOP-Bang score and AHI in bariatric patients, STOP-Bang scores above 3 did predict OSA in 80% of the patients. It remains a useful and quick screening tool for preoperative assessment of OSA.

DISCLOSURE: The following authors have nothing to disclose: Kristin Fless, Prakash Paragi, Ravali Tarigopula, Conor Wentworth, Raj Patel

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