High-Risk Obstructive Sleep Apnea Linked to Longer Hospitalizations, Postoperative Complications

OSA obstructive sleep apnea illustration
Patients identified as having high-risk obstructive sleep apnea by the STOP-Bang Questionnaire were more likely to have postoperative complications and longer hospital stays.

Patients identified by the STOP-Bang (Snoring, Tired, Observed, Pressure-Body Mass Index, Age >50 years, Neck Size Large, Gender = Male) Questionnaire as having high-risk obstructive sleep apnea (HR-OSA) may have a higher risk for postoperative complications and longer hospitalizations compared with patients identified as having low-risk obstructive sleep apnea (LR-OSA) according to a study published in Anesthesia & Analgesia.

Researchers identified 23,609 patients (HR-OSA: n=7877; LR-OSA: n=15,732) from 10 cohort studies who were screened for OSA using the STOP-Bang questionnaire prior to a surgical procedure, and who had at least one postoperative cardiopulmonary or other complication resulting in an intensive care unit admission.

The results demonstrated a 3.9-fold higher rate of complications in patients with HR-OSA compared with patients with LR-OSA (pooled odds ratio [OR], 3.93, 95% credible interval [CrI], 1.85-7.77, P =.003). In addition, length of hospital stay was found to be 2.1 days longer in patients with HR-OSA vs LR-OSA (5.0±4.2 days vs 3.4±2.8 days; pooled mean difference, 2.01; 95% CrI, 0.77-3.24, P =.005). Meta-regression and subgroup analyses did not materially change the results.

The investigators concluded that patients identified by the STOP-Bang Questionnaire as having HR-OSA had longer hospitalizations and an almost 4-fold increased risk for postoperative complications, thereby supporting the implementation of the STOP-Bang Questionnaire as a preoperative risk assessment tool.

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Magappa M, Patra J, Wong J, et al.  Association of STOP-Bang Questionnaire as a screening tool for sleep apnea and postoperative complications: a systematic review and Bayesian meta-analysis of prospective and retrospective cohort studies [published online August 11, 2017].  Anesth Analg. doi:10.1213/ANE.0000000000002344