Obstructive sleep apnoea predicted by the STOP-BANG questionnaire is not associated with higher rates of post-operative complications among a high-risk surgical cohort

• Published in: Sleep & breathing 2020-03, Vol.24 (1), p.135-142
• Main Authors: Wong, Ai-Ming, Wang, Michael, Garner, Daniel J., Bowditch, Sara, Paul, Eldho, Adams, Mark J., Hamilton, Garun S., Mansfield, Darren R.
• Format: Article
• Language: English
• Subjects: Aged; Apnea; Body mass index; Child; Cohort Studies; Correlation of Data; Dentistry; Female; Humans; Infant; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Nervous System Diseases; Neurological complications; Neurology; Otorhinolaryngology; Patients; Pediatrics; Pneumology/Respiratory System; Postoperative Complications - diagnosis; Predictive Value of Tests; Questionnaires; Risk Factors; Sleep; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Breathing Physiology and Disorders • Original Article; Sleep disorders; Surgery; Surveys and Questionnaires
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-019-01825-3

Purpose The purpose of this study is to establish if obstructive sleep apnoea (OSA) predicted by the STOP-BANG questionnaire would be associated with higher rates of post-operative cardiac, respiratory or neurological complications among a selected high-risk population with established major comorbidities undergoing major surgery. We hypothesise that a cohort selected for major comorbidities will show a higher post-operative complication rate that may power any potential association with co-existent OSA and identify an important target group for OSA screening and treatment pathways in preparation for major surgery. Methods Patients attending a high-risk preadmission clinic prior to major surgery from May 2015 to November 2015 were prospectively screened for OSA using the STOP-BANG questionnaire. Patients with treated OSA were excluded. Patient data and complications were attained from the pre-admission clinic and subsequent inpatient medical record at discharge. Results Three-hundred-and-ten patients were included in the study (age 68.6 ± 13.1 years, body mass index [BMI] 30.6 ± 7.4 kg/m 2 ; 52.9% female). Sixty-four patients (20.6%) experienced 82 post-operative complications. Seventy-five percent of the cohort had a STOP-BANG ≥ 3. There was no association between the STOP-BANG score (unadjusted and adjusted for comorbidity) with the development of post-operative complications. Conclusions OSA predicted by the STOP-BANG score was not associated with higher rates of post-operative complications in patients with major comorbidities undergoing high-risk surgery. As the findings from this cohort contrast with other observational studies, more definitive studies are required to establish a causative link between OSA and post-operative complications and determine whether treating OSA reduces this complication rate.