Evidence-based Practice and Quality Improvement
Background and Goal of Study: The Obstructive Syndrome Apnea (OSA) has been described as a risk factor for post-operative adverse event. STOP-BANG score (snore; tired; observed apnea; arterial pressure; body mass index; age; neck circumference and gender) can predict the risk of a patient to have OSA, when that score is > 3. The aim of this study was to evaluate the incidence STOP-BANG score > 3, in surgical patients admitted in the Post-Anesthesia Care Unit (PACU).
Materials and Methods: Observational, prospective study conducted in a post-anaesthesia care unit (PACU) during three weeks (2011). The study population consisted in 357 adult patients after non cardiac and nonneurologic surgery. Patients' demographics, intraoperative and postoperative data were collected. We also recorded PACU and hospital length of stay (LOS). Patients' characteristics were compared using Mann-Whitney U test, t test for independent groups, chi-square or Fisher's exact test.
Results and Discussion: A total of 357 patients were admitted to de PACU and of these, 340 met the inclusion criteria. 179 (52%) had a STOP-BANG score > 3. These patients were older (62 vs. 49 years, p < 0.001), were more likely to be masculine (63% vs. 21%, p < 0.001), had higher BMI (28 kg.m-2 vs. 24 kg.m-2, p < 0.001); had a higher ASA physical status (ASA III, IV or V 26% vs. 10%, p < 0.001); had an higher incidence of ischemic heart disease (10% vs. 2%, p=0.001), heart failure (8% vs. 3%, p=0.032), hypertension (62% vs. 19%, p < 0.001), hyperlipidemia (41% vs. 12%, p < 0.001) and underwent more frequently insulin treatment for diabetes (24% vs. 4%, p < 0.001). These patients had more frequently mild/moderated hypoxia in the PACU (9% vs. 3%, p=0.012) and had a higher incidence of residual neuromuscular blockade (NMB) (20% vs. 16%, p=0.035). Patients with STOP-BANG score > 3 had a higher length of hospital stay (5 days vs. 3 days, p=0.01).
Conclusion(s): Patients with STOP-BANG score ≥ 3 had an important incidence among patients scheduled to surgery in our hospital. These patients had more co-morbilities and were more prone to have post-operative complications like residual NMB and respiratory events. They also had a longer hospital stay.