Validation of the STOP-Bang questionnaire as a preoperative screening tool for obstructive sleep apnea: a systematic review and meta-analysis

Mark Hwang; Mahesh Nagappa; Nasimi Guluzade; Aparna Saripella; Marina Englesakis; Frances Chung

doi:10.1186/s12871-022-01912-1

Validation of the STOP-Bang questionnaire as a preoperative screening tool for obstructive sleep apnea: a systematic review and meta-analysis

BMC Anesthesiol. 2022 Nov 30;22(1):366. doi: 10.1186/s12871-022-01912-1.

Authors

Mark Hwang^{1

2}, Mahesh Nagappa³, Nasimi Guluzade², Aparna Saripella², Marina Englesakis⁴, Frances Chung^{5

6}

Affiliations

¹ Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
² Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, M5T 2S8, Canada.
³ Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
⁴ Library and Information Services, University Health Network, Toronto, ON, Canada.
⁵ Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, M5T 2S8, Canada. frances.chung@uhn.ca.
⁶ Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada. frances.chung@uhn.ca.

Abstract

Background: Obstructive sleep apnea (OSA) is a common disorder that is highly associated with postoperative complications. The STOP-Bang questionnaire is a simple screening tool for OSA. The objective of this systematic review and meta-analysis is to evaluate the validity of the STOP-Bang questionnaire for screening OSA in the surgical population cohort.

Methods: A systematic search of the following databases was performed from 2008 to May 2021: MEDLINE, Medline-in-process, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO, Journals @ Ovid, Web of Science, Scopus, and CINAHL. Continued literature surveillance was performed through October 2021.

Results: The systematic search identified 4641 articles, from which 10 studies with 3247 surgical participants were included in the final analysis. The mean age was 57.3 ± 15.2 years, and the mean BMI was 32.5 ± 10.1 kg/m² with 47.4% male. The prevalence of all, moderate-to-severe, and severe OSA were 65.2, 37.7, and 17.0%, respectively. The pooled sensitivity of the STOP-Bang questionnaire for all, moderate-to-severe, and severe OSA was 85, 88, and 90%, and the pooled specificities were 47, 29, and 27%, respectively. The area under the curve for all, moderate-to-severe, and severe OSA was 0.84, 0.67, and 0.63.

Conclusions: In the preoperative setting, the STOP-Bang questionnaire is a valid screening tool to detect OSA in patients undergoing surgery, with a high sensitivity and a high discriminative power to reasonably exclude severe OSA with a negative predictive value of 93.2%.

Trial registration: PROSPERO registration CRD42021260451 .

Keywords: Meta-analysis; Obstructive sleep apnea; STOP-bang questionnaire; Screening questionnaire; Surgical population; Systematic review.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Databases, Factual
Female
Humans
Male
Middle Aged
Postoperative Complications
Research
Sleep Apnea, Obstructive* / diagnosis
Surveys and Questionnaires