ICU Literature Updates from January 2014

The Association of Pre-Operative STOP-BANG Scores With Postoperative Critical Care Admission

Obstructive sleep apnea is known to be under diagnosed with an estimated 1 in 3 elective surgical patients possible suffering from this disease. Sleep apnea is of concern to the anesthesiologist and critical care physician for a variety of reasons, none the least of which are an associated increase in myocardial infarction, respiratory failure and cardiac arrest. The STOP-BANG questionnaire is an easy to use, well know, validated tool to screen for obstructive sleep apnea. In this study, the authors retrospectively analyzed the association of STOP-BANG score with ICU admission. The authors hypothesized that a high score would be associated with greater ICU admission. After evaluating 5432 patients who underwent elective surgery, 338 (6.2%) were admitted postoperatively to a critical care unit. The authors found that the STOP-BANG score; age; asthma; a history of obstructive sleep apnea; and ASA physical status was independent predictors of ICU admission. With regards to the STOP-BANG questionnaire, A STOP-BANG score of 6 or more was associated with a fivefold increased rate of postoperative critical care unit admission when compared to a score of 2 or less. Therefore, it appears that the STOP-BANG questionnaire could be a useful tool to also stratify patients for ICU admission.