Elevated Risk for Obstructive Sleep Apnea in Patients presenting for Surgeries at a Tertiary Hospital in Nepal: A STOP-BANG Questionnaire Study

Abstract

Introduction: Obstructive sleep apnea (OSA) can lead to significant perioperative risks like difficult airway management, prolonged hospital stays and increased incidence of morbidity and mortality. We aimed to estimate the proportion of surgical patients with elevated risk for OSA during pre-anesthesia checkup at a tertiary hospital in Nepal.

Methods: This was a cross-sectional study which was conducted among 318 surgical patients presenting for Pre-anaesthetic checkup at PAC clinic. Two validated screening tools, the STOP-BANG questionnaire and Epworth Sleepiness Scale (ESS), were used. Data on demographics, comorbidities, and OSA risk factors were collected and analyzed. STOP-BANG score ≥3 was defined as elevated risk for OSA. Those patients who complained of daytime somnolence were further assessed for its severity with ESS. Statistical analysis was done with independent sample t-test, chi-square test and logistic regression.

Results: It was found that 23.58% of the participants had elevated risk for OSA (STOP-BANG >3). The risk was significantly associated with advancing age, males, obesity, increased neck circumference, hypertension, diabetes and hyperlipidemia. A weak but significant correlation was found between ESS and STOP-BANG scores (r=0.412, p=0.045).

Conclusions: Proportion of patients with elevated risk for OSA was high in our surgical population. Undiagnosed OSA can have various perioperative complications, hence, we should routinely screen patients using questionnaires like STOP-BANG.