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80.5% of Hospital Patients Are at High Risk for Sleep Apnea
"MAYWOOD, Ill. -- Eighty-one percent of hospital patients are at high
risk for obstructive sleep apnea, a Loyola University Health System study has
found.
risk for obstructive sleep apnea, a Loyola University Health System study has
found.
The findings suggest that hospitals should consider giving patients a five-minute screening test to identify those who are at high risk."
Full article: http://www.healthcanal.com/public-health-safety/12132-Loyola-Study-...
Astounding.
Views: 125
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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Hospitals do give pts a five minute screening test. Little behind the times on this one Rooster. Search the Stop Bang program. it is the screening process model used by a great majority of hospitals.
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Somebody died a couple of years back and changed everything. I am currently working at the first hospital to initaiate the screening process. This has been a great learning process for me. The majority of the hospitals out there have a screening processs in place. now that does not mean that your admitting person is going to do it. I screen and educate about 50 people a week at my current location. Three other techs do the same. The last hospital I worked at screened over 15000 people last year.
Mary Z said:Rock, admittedly I haven't had more than five different visits to the hospital in the past five years, but I've never had a questionaire, or even any questions about sleep from the anesthesiologist. And most of our hospitals are teaching hospitals due to the medical school, EVMS, being in Norfolk, VA, my home town.
Rock Hinkle said:Hospitals do give pts a five minute screening test. Little behind the times on this one Rooster. Search the Stop Bang program. it is the screening process model used by a great majority of hospitals.
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Permalink Reply by Banyon on
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Rock, If you knew how to read you would understand that the article is about finding 80% of the patients at risk. That is news that I saw for the first time when I logged in this morning. I know sleep apnea is highly prevalent in hospital patients, but I would not have guessed that high.
I am very skeptical about your claim that the majority of hospitals screen. Evidence?
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If I knew how to read huh? it seems that know more about what goes on in my industry then I do.
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The stop bang program is used in many hospitals nation wide PRESENTLY
http://journals.lww.com/anesthesiology/Fulltext/2008/05000/STOP_Que...
http://www.philly.com/philly/blogs/healthcare/STOP_BANG_test_for_sl...
Friday, October 22, 2010
STOP BANG test for sleep apnea
By Inquirer Staff Writer Marie McCullough:
STOP-BANG sounds like a heavy metal rock band, but it's actually a simple questionnaire to screen people for sleep apnea.
Now, Thomas Jefferson University researchers have a study that shows the test can identify patients who are likely to suffer complications after surgery and thus need special care.
The questionnaire, developed and validates by Canadian anesthesiologists a few years ago, poses eight yes-or-no questions about risk factors for apnea, a common disorder in which people periodically stop breathing during sleep. Patients are asked about about Snoring, Tiredness during the day, Observed apnea, high blood Pressure, Body mass index, Age, Neck cicumference, and Gender.
People with apnea are more likely to suffer lung or heart complications such as embolism or pneumonia after surgery, but most surgical patients with apnea have not been diagnosed. Overnight sleep testing in a medical facility is the gold standard for diagnosis.
Using STOP-BANG, the Jefferson researchers, led by Tajender Vasu, found that 56 out of 180 patients (41 percent) scheduled for surgery were at high risk of apnea. Patients with high-risk STOP—BANG scores turned out to have higher rates of postoperative complications — 19.6 percent compared to 1.3 percent for patients with low-risk scores. In other words, apnea raises the risk of complications tenfold.
The next question for researchers is what to do for such patients. Theoretically, the researchers say, they could benefit from postsurgical use of a standard apnea treatment called CPAP, a device that increases nasal airway pressure to prevent interuptions in breathing.
The study appears in the October issue of Archives of Otolaryngology - Head and Neck Surgery.
To check out more Check Up items go to www.philly.com/checkup.
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http://www.ncbi.nlm.nih.gov/pubmed/20419474
Sleep Breath. 2010 Apr 26. [Epub ahead of print]
Simplifying STOP-BANG: use of a simple questionnaire to screen for OSA in an Asian population.
Ong TH, Raudha S, Fook-Chong S, Lew N, Hsu AA.
Sleep Disorders Unit, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore, ong.thun.how@sgh.com.sg.
Abstract
OBJECTIVE: We aim to assess the utility of a simple-to-use 8-point questionnaire in screening for moderate-severe obstructive sleep apnea (OSA) and to assess the validity of cutoffs used to score body mass index (BMI) in this questionnaire.
METHODS: Patients undergoing diagnostic polysomnography (PSG) were asked to fill in a questionnaire with a simple dichotomized 8-point questionnaire, represented by the mnemonic STOP-BANG. A score of 3 or more out of a possible 8 was taken to indicate high risk for presence of OSA. These were then evaluated versus results from the overnight, monitored PSG.
RESULTS: Three hundred and forty-eight patients underwent overnight diagnostic PSG, of whom 319 (91.2%) completed the questionnaire. Seventy-four (22.7%) were classified as being at low risk of OSA and 252 (77.3%) were classified as being high risk. The sensitivities of the STOP-BANG screening tool for an AHI of >5, >15, and >30 were 86.1%, 92.8%, and 95.6%, respectively, with negative predictive values of 84.5% and 93.4% for moderate and severe OSA, respectively. Using cutoffs of 30 or 35 for scoring the BMI did not significantly change the performance of the screening tool.
CONCLUSION: STOP-BANG is a clinically useful tool with high sensitivity that can be used to screen patients for moderate and severe OSA. Using cutoffs of 30 for BMI, 40 cm for neck circumference, and 50 years for age simplifies the application of the tool without affecting performance.
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http://archotol.ama-assn.org/cgi/content/short/136/10/1020?rss=1
Obstructive Sleep Apnea Syndrome and Postoperative Complications
Clinical Use of the STOP-BANG Questionnaire
Tajender S. Vasu, MD; Karl Doghramji, MD; Rodrigo Cavallazzi, MD; Ritu Grewal, MD; Amyn Hirani, MD; Benjamin Leiby, PhD; Dimitri Markov, MD; David Reiter, MD; Walter K. Kraft, MD; Thomas Witkowski, MD
Arch Otolaryngol Head Neck Surg. 2010;136(10):1020-1024. 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.
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The stop bang program has been in effect in most hospitals for a few years now. My current employer has been using this system for almost five years. The program originated at St. Mary Corwin in Pueblo Colorado before taking off.
I ask again why the insults to prove your point banyon? It is not my fault that you are just finding out about a program that has been in effect for some time. There was an article on SG about 6 months ago covering the same topic.
http://www.sleepguide.com/forum/topics/hospitals-should-screen-for.
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I would say not all that many on this site. You nor I came to sleepguide because our first experiences in sleep were good. The majority of the members are here because someone did not do their job properly. Does that mean that the entire industry is bad? I would hope not. My part of it surely is not. There are many people out there whom have gotten wonderful treatment from there sleep team. Unfortunately they have no reason to speak out. Even if they did one "oh shit" deletes 100 "good jobs" in our society. In the case of sleepguide it would be 4700 "oh shits" to 1 mil "good jobs".
Choosing a sleep lab is just as important as any other decision made in life. It needs to be researched like any other financial decision. Most of my patients have no clue about the lab or anything that we do in it. Is that the sleep industries fault? No it is the PCP that is supposed to provide communication and education to there patients. The same PCP who is supposed to be running the invaluable HST that everyone here is so fond of. Maybe them having control of this procedure would improve the doctor education. I know it will improve there bank accounts which is probably the only reason they are willing to do it in the first place. If they actually cared they would have already obtained the knowledge needed to take care of there pts. Come on people! You are gettin hoodwinked by the insurance company lobbyist(banyon) and don't even realize it.
There are many of us out there fighting for improvements. The personal attacks only set us.
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Permalink Reply by Donna B. on
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My father in-law had a cancerous kidney removed a few weeks ago. He suffers from OSA. He had "throat surgery" a few years back, (his words), to correct the OSA. He never went back for a follow up sleep test. My concern is that the hospital, doctors, or anesthesiologist did not ask if he had trouble sleeping. He spent 13 days recovering in the hospital. My FIL is a classic, obvious OSA patient, he is obese, has HBP, diabetes, and very large neck size !!
I told my husband to ask the doctor at his dad's follow up if his OSA should be re-checked now that his body is working with only one kidney and the fact that he has HBP, diabetes and is obese.
The doctor replied "No, we are not concerned". I can't seem to get either one of these men in my life to understand the severity of this. I AM beyond concerned for his health now, what to do ??
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Mary, It is not just the hospital I work at. All 3 of the hosptials I work at have used the Stop Bang program. I have talked to techs all over the country that use some sort of screening process. We have talked about it here. I know that it is not a perfect system, but we are trying. These discussions point to the sleep community not doing anything. That is just not true. My point in original post was that this is old information. That seems to be the way sleep works.
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