High STOP-Bang score indicates a high probability of obstructive sleep apnoea

F Chung, R Subramanyam, P Liao, E Sasaki, C Shapiro, Y Sun, F Chung, R Subramanyam, P Liao, E Sasaki, C Shapiro, Y Sun

Abstract

Background: The STOP-Bang questionnaire is used to screen patients for obstructive sleep apnoea (OSA). We evaluated the association between STOP-Bang scores and the probability of OSA.

Methods: After Institutional Review Board approval, patients who visited the preoperative clinics for a scheduled inpatient surgery were approached for informed consent. Patients answered STOP questionnaire and underwent either laboratory or portable polysomnography (PSG). PSG recordings were scored manually. The BMI, age, neck circumference, and gender (Bang) were documented. Over 4 yr, 6369 patients were approached and 1312 (20.6%) consented. Of them, 930 completed PSG, and 746 patients with complete data on PSG and STOP-Bang questionnaire were included for data analysis.

Results: The median age of 746 patients was 60 yr, 49% males, BMI 30 kg m(-2), and neck circumference 39 cm. OSA was present in 68.4% with 29.9% mild, 20.5% moderate, and 18.0% severe OSA. For a STOP-Bang score of 5, the odds ratio (OR) for moderate/severe and severe OSA was 4.8 and 10.4, respectively. For STOP-Bang 6, the OR for moderate/severe and severe OSA was 6.3 and 11.6, respectively. For STOP-Bang 7 and 8, the OR for moderate/severe and severe OSA was 6.9 and 14.9, respectively. The predicted probabilities for moderate/severe OSA increased from 0.36 to 0.60 as the STOP-Bang score increased from 3 to 7 and 8.

Conclusions: In the surgical population, a STOP-Bang score of 5-8 identified patients with high probability of moderate/severe OSA. The STOP-Bang score can help the healthcare team to stratify patients for unrecognized OSA, practice perioperative precautions, or triage patients for diagnosis and treatment.

Figures

Fig 1
Fig 1
Screening flow chart of patients. PSG, polysomnography.
Fig 2
Fig 2
Distribution of patients according to their STOP-Bang score.
Fig 3
Fig 3
Plot of predicted probabilities for AHI cut-offs of >5, >15, and >30 with the corresponding STOP-Bang score. The vertical bars indicate the 95% confidence intervals. STOP-Bang scores of 0, 1, and 2 are grouped together and are shown as score 2. Scores 7 and 8 are grouped together and is shown as score 7. As the STOP-Bang scores increased, the predicted probabilities were greater. AHI, apnoea–hypopnoea index.

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