Obstructive sleep apnea in general surgery patients: is it more common than we think?

Gaurav V Kulkarni, Anne Horst, Joshua M Eberhardt, Sunita Kumar, Sharfi Sarker
American Journal of Surgery 2014, 207 (3): 436-40; discussion 439-40

BACKGROUND: To determine the risk of obstructive sleep apnea (OSA) in preoperative surgical patients.

METHODS: Three hundred seventy-one new patients presenting to an outpatient general surgery clinic were prospectively screened for risk of OSA using the STOP-Bang questionnaire. Patients were classified as high risk with a score of >3 on the STOP-Bang questionnaire. Polysomnography results were reviewed when available.

RESULTS: Complete questionnaires were available on 367 (98.9%) patients. Two hundred thirty-seven patients (64.6%) were classified as high risk of OSA on the questionnaire. Polysomnography results available on 49 patients revealed severe OSA in 17 (34.5%), moderate in 8 (16.5%), mild in 14 (28.5%), and no OSA in 10 (20.5%) patients. The positive predictive value and sensitivity of the questionnaire were 76%, and 92% for the STOP-Bang questionnaire, respectively. The sensitivity increased to 100% for severe OSA.

CONCLUSION: Preoperative screening for OSA should be considered to diagnose patients at risk.

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