Obstructive sleep apnea syndrome and postoperative complications: clinical use of the STOP-BANG questionnaire

Arch Otolaryngol Head Neck Surg. 2010 Oct;136(10):1020-4. doi: 10.1001/archoto.2010.1020.


Objective: To determine whether high risk scores on preoperative STOP-BANG (Snoring, Tiredness during daytime, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, Gender) questionnaires during preoperative evaluation correlated with a higher rate of complications of obstructive sleep apnea syndrome (OSAS).

Design: Historical cohort study.

Setting: Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

Patients: Adult patients undergoing elective surgery at a tertiary care center who were administered the STOP-BANG questionnaire for 3 consecutive days in May 2008.

Main outcome measures: Number and types of complications.

Results: A total of 135 patients were included in the study, of whom 56 (41.5%) had high risk scores for OSAS. The mean (SD) age of patients was 57.9 (14.4) years; 60 (44.4%) were men. Patients at high risk of OSAS had a higher rate of postoperative complications compared with patients at low risk (19.6% vs 1.3%; P < .001). Age, American Society of Anesthesiologists class of 3 or higher, and obesity were associated with an increased risk of postoperative complications. On multivariate analysis, high risk of OSAS and American Society of Anesthesiologists class 3 or higher were associated with higher odds of complications.

Conclusion: The STOP-BANG questionnaire is useful for preoperative identification of patients at higher than normal risk for surgical complications, probably because it identifies patients with occult OSAS.

MeSH terms

  • Age Factors
  • Body Mass Index
  • Cohort Studies
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Obesity / complications
  • Postoperative Complications*
  • Preoperative Care
  • Risk Assessment*
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / classification
  • Sleep Apnea, Obstructive / complications*
  • Surgical Procedures, Operative / statistics & numerical data
  • Surveys and Questionnaires*