Questionnaire helps to identify patients at risk for surgical complications

October 18, 2010

A simple, eight-item pre-operative questionnaire could help identify patients at risk for complications following surgery, according to a report in the October issue of Archives of Otolaryngology–Head & Neck Surgery, one of the JAMA/Archives journals. Individuals prone to the obstructive sleep apnea syndrome as determined by the questionnaire appear to have an increased risk of heart, lung and other complications following elective surgery.

Obstructive sleep apnea, a disorder in which individuals periodically stop breathing during sleep, occurs in approximately 5 percent to 9 percent of the general population, according to background information in the article. The condition may be more common among patients undergoing surgery, and the related cardiorespiratory consequences may be exacerbated following surgical procedures because anesthetic agents and pain relievers decrease muscle tone in the upper airways and diminish control of breathing. "Therefore, it is important to identify surgical patients who are at high risk for obstructive sleep apnea syndrome," the authors write.

Polysomnography conducted in a sleep laboratory and home sleep testing have both been used to diagnose obstructive sleep apnea. However, neither procedure has been used extensively among patients preparing for surgery, the authors note. Tajender S. Vasu, M.D., and colleagues at Thomas Jefferson University Hospital, Philadelphia, studied 135 patients undergoing elective surgery in May 2008. Before their procedures, all the patients completed the STOP-BANG (Snoring, Tiredness during daytime, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference and Gender) , which consists of eight yes-or-no questions to assess apnea risk.

Of the patients, 56 (41.5 percent) had high scores on STOP-BANG, indicating a high risk for obstructive sleep apnea and 12 (8.9 percent) experienced heart or lung-related complications. Patients with higher scores on STOP-BANG had increased rates of postoperative complications (19.6 percent vs. 1.3 percent) and longer hospital stays (3.6 days vs. 2.1 days) compared with patients who had lower scores.

"The high rate of postoperative complications in patients with obstructive sleep apnea syndrome may be owing to a variety of reasons," the authors write. "Central nervous system suppression owing to anesthesia, sedation and analgesia [pain relief] can foment sleep-disordered breathing and further asphyxia-related complications." In addition, rapid eye movement (REM) sleep is diminished the night after surgery, followed by a period of REM rebound. The occurrence of breathing problems during REM sleep can consequently triple on the second and third postoperative nights.

"Most patients with obstructive syndrome have undiagnosed conditions and are almost certainly at risk in the perioperative setting," the time period immediately after surgery, the authors write. "The STOP-BANG questionnaire is a convenient and useful screening tool that appears to reliably identify patients who are at increased risk for postoperative complications."

More information: Arch Otolaryngol Head Neck Surg. 2010;136[10]:1020-1024.

Related Stories

Recommended for you

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.