Asking patients four simple yes/no questions can help reduce rates of surgical complications, Canadian researchers report. The four questions, termed the STOP questionnaire, relate to snoring, tiredness during daytime, observed apnea during sleep, and high blood pressure. It's designed to identify patients with obstructive sleep apnea (OSA), which is associated with more difficult intubation, higher incidence of postoperative complications, increased intensive care admissions, and longer hospital stays.
In a study, researchers gave the questionnaire to 2,467 preoperative patients ages 18 and older who weren't previously identified as having OSA. To validate findings, 177 patients underwent polysomnography where an apnea-hypopnea index was measured.
Patients were asked these four questions:
* Do you snore loudly?
* Do you often feel tired, fatigued, or sleepy during daytime?
* Has anyone observed you stop breathing during sleep?
* Do you have or are you being treated for high blood pressure?
Patients who answered yes to two or more questions were considered at high risk for OSA. Researchers found that when questionnaire results were combined with other known risk factors for OSA, the ability to predict OSA was even greater, especially for moderate to severe OSA. Risk factors include a high body mass index, age older than 50 years, large neck circumference, and male sex.
Although an overnight sleep study is the best way to diagnose OSA, it's too expensive and impractical to use as a screening tool. This simple questionnaire can help anesthesia providers and other clinicians identify patients with OSA and reduce the risk of postoperative complications.
Source: Chung F, et al., STOP questionnaire: a tool to screen patients for obstructive sleep apnea, Anesthesiology, May 2008.