Abstract
Background
OSA is common in the adult populationand a high proportion of sufferers remain undiagnosed and may be presenting for surgery. There is a move towards pre-operative screening for OSA and the STOP-BANG questionnaire has been previously validated in a general surgical population. To our knowledge this questionnaire has not yet been validated in a cardiac surgical population.
Aims
To assess the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the STOP-BANG at various scores to predict OSA in patients undergoing CABG surgery.
Methods
Patients were screened for high risk of OSA with the STOP-BANG questionnaire. The presence of OSA, prior to surgery, was assessed with overnight oximetry. Sleep apnoea was defined as a 4% oxygen desaturation index (ODI) of ≥5/hr. The sensitivity, specificity, PPV and NPV of STOP-BANG were assessed at the ODI cut-off value of ≥5/hr and ≥15/hr.
Results
Out of 94 patients 44 (47%) had a new diagnosis of OSA.
Conclusion
In our patient cohort, STOP-BANG at various scores has high sensitivity but lacks the specificity to identify high risk OSA patients, which may lead to inappropriate utilisation of sleep diagnostics in the pre-operative stage and possible delays in surgery. The cardiac surgical population is preselected as male, older and suffering with hypertension and as such many patients will automatically score as high risk for OSA.
- © 2014 ERS