The correlation between the STOP-Bang score and oxygen saturation during spinal anesthesia with dexmedetomidine sedation

Background: The STOP-BANG questionnaire is a simple screening tool with high sensitivity for the detection of severe obstructive sleep apnea (OSA). Predicting airway obstruction would allow the safe management of sedative patients to prevent intraoperative hypoxia. This study was designed to check the correlation between the STOP-BANG score and oxygen saturation (SpO2) during sedation and confirm the availability of the STOP-BANG questionnaire as a preoperative exam for predicting the incidence of hypoxia in sedative patient management.Methods: This study included 56 patients who received spinal anesthesia. The pre-anesthesia evaluation was conducted using the STOP-Bang questionnaire. The patients were under spinal anesthesia with an average block level of T10. Dexmedetomidine was infused with a loading dose of 1 μg/kg over 10 min and a maintenance dose of 0.5 μg/kg/h until the end of the procedure. The SpO2 of the patients was recorded every 5 min.Results: The STOP-Bang score was negatively correlated with the lowest SpO2 (coefficient = –0.774, 95% confidence interval [CI]: –0.855 to –0.649, standard error [SE] = 0.054, P < 0.001). The item of “observed apnea” was the most correlated one with hypoxic events (odds ratio = 6.00, 95% CI: 1.086 to 33.145).Conclusions: The STOP-BANG score was significantly correlated with the lowest SpO2 during spinal anesthesia, which enabled the prediction of meaningful hypoxia before it occurred in the sedated patients.

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Rethinking neck circumference in STOP-BANG for Asian OSA

Proceedings of Singapore Healthcare ◽

10.1177/2010105818810272 ◽

2018 ◽

Vol 28 (2) ◽

pp. 105-109 ◽

Cited By ~ 1

Author(s):

John Ming-Ren Loh ◽

Song-Tar Toh

Keyword(s):

Retrospective Analysis ◽

Screening Tool ◽

Sleep Apnoea ◽

Neck Circumference ◽

Receiver Operating Curve ◽

Asian Populations ◽

Asian Patients ◽

Obstructive Sleep ◽

Males And Females ◽

Simple Screening

Introduction: The STOP-BANG questionnaire is a simple screening tool for obstructive sleep apnoea (OSA) which has been validated for use in Asian populations. The original cut-off values for neck circumference were defined based on Caucasian populations. This study aims to validate the neck circumference component of the STOP-BANG score in Asians. Methods: A retrospective analysis of all patients suspected of having OSA who underwent a diagnostic polysomnography at a tertiary sleep centre in Singapore over the course of 1 year was conducted. Neck circumference was measured and correlated to the presence of OSA. A receiver operating curve was performed to obtain the optimal cut-off value for screening OSA in Asian patients. Results: 591 Asian subjects with OSA were analysed. The optimal neck circumference predictive for OSA was found to be 39 cm in males and 35 cm in females, with a sensitivity of 83.4% and 84.6% respectively. The existing STOP-BANG cut-off of 40 cm had 71% and 32% sensitivity in Asian males and females, respectively. Conclusion: The STOP-BANG cut-off value for neck circumference for screening for sleep apnoea in Asian males can be maintained at 40 cm, but the neck circumference value used for screening Asian females should be lowered to 35 cm.

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The NoSAS score: A new and simple screening tool for obstructive sleep apnea syndrome in depressive disorder

Journal of Affective Disorders ◽

10.1016/j.jad.2017.10.015 ◽

2018 ◽

Vol 227 ◽

pp. 136-140 ◽

Cited By ~ 8

Author(s):

Kelly Guichard ◽

Helena Marti-Soler ◽

Jean-Arthur Micoulaud-Franchi ◽

Pierre Philip ◽

Pedro Marques-Vidal ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Depressive Disorder ◽

Obstructive Sleep Apnea Syndrome ◽

Screening Tool ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Apnea Syndrome ◽

Simple Screening

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STOP Questionnaire

Anesthesiology ◽

10.1097/aln.0b013e31816d83e4 ◽

2008 ◽

Vol 108 (5) ◽

pp. 812-821 ◽

Cited By ~ 969

Author(s):

Frances Chung ◽

Balaji Yegneswaran ◽

Pu Liao ◽

Sharon A. Chung ◽

Santhira Vairavanathan ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Screening Tool ◽

High Sensitivity ◽

Surgical Patients ◽

Apnea Hypopnea Index ◽

Neck Size ◽

Obstructive Sleep ◽

And Gender ◽

Stop Questionnaire

Background Obstructive sleep apnea (OSA) is a major risk factor for perioperative adverse events. However, no screening tool for OSA has been validated in surgical patients. This study was conducted to develop and validate a concise and easy-to-use questionnaire for OSA screening in surgical patients. Methods After hospital ethics approval, preoperative patients aged 18 yr or older and without previously diagnosed OSA were recruited. After a factor analysis, reliability check, and pilot study; four yes/no questions were used to develop this screening tool. The four questions were respectively related to snoring, tiredness during daytime, observed apnea, and high blood pressure (STOP). For validation, the score from the STOP questionnaire was evaluated versus the apnea-hypopnea index from monitored polysomnography. Results The STOP questionnaire was given to 2,467 patients, 27.5% classified as being at high risk of OSA. Two hundred eleven patients underwent polysomnography, 34 for the pilot test and 177 for validation. In the validation group, the apnea-hypopnea index was 20 +/- 6. The sensitivities of the STOP questionnaire with apnea-hypopnea index greater than 5, greater than 15, and greater than 30 as cutoffs were 65.6, 74.3, and 79.5%, respectively. When incorporating body mass index, age, neck circumference, and gender into the STOP questionnaire, sensitivities were increased to 83.6, 92.9, and 100% with the same apnea-hypopnea index cutoffs. Conclusions The STOP questionnaire is a concise and easy-to-use screening tool for OSA. It has been developed and validated in surgical patients at preoperative clinics. Combined with body mass index, age, neck size, and gender, it had a high sensitivity, especially for patients with moderate to severe OSA.

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Can Assessment for Obstructive Sleep Apnea Help Predict Postadenotonsillectomy Respiratory Complications?

Anesthesiology ◽

10.1097/00000542-200202000-00015 ◽

2002 ◽

Vol 96 (2) ◽

pp. 313-322 ◽

Cited By ~ 128

Author(s):

Kerryn Wilson ◽

Indrani Lakheeram ◽

Angie Morielli ◽

Robert Brouillette ◽

Karen Brown

Keyword(s):

Confidence Interval ◽

Oxygen Saturation ◽

Odds Ratio ◽

Medical Condition ◽

Respiratory Complications ◽

Obstructive Apnea ◽

Sleep Studies ◽

Obstructive Sleep ◽

Increased Risk ◽

Postoperative Respiratory Complications

Background The aim of this study was to determine the frequency and type of respiratory complications after adenotonsillectomy in children. A second aim was to assess the ability of preoperative sleep studies to identify children at risk for respiratory complications. Methods Children referred for sleep studies between 1992 and 1998, who underwent adenotonsillectomy within 6 months of the preoperative study, were reviewed. The study focused on two variables: the obstructive apnea and hypopnea index and the oxygen saturation nadir. Medical charts were reviewed for postoperative respiratory complications. Results Three hundred forty-nine children were referred for sleep studies, and 163 met the inclusion criteria. Thirty-four children (21%) had postoperative respiratory complications requiring a medical intervention. Children experiencing respiratory complications were younger (aged < 2 yr; adjusted odds ratio, 4.3; 95% confidence interval, 1.7-11) and had an associated medical condition (odds ratio, 3; 95% confidence interval, 1.4-6.5). A preoperative obstructive apnea and hypopnea index of 5 or more events per hour increased the chance of postoperative respiratory complications (odds ratio, 7.2; 95% confidence interval, 2.7-19.3), as did a preoperative oxygen saturation nadir of 80% or less (odds ratio, 6.4; 95% confidence interval, 2.8-14.5). A preoperative oxygen saturation nadir of 80% or less had a likelihood ratio of 3.1, increasing the probability of postoperative respiratory complications from 20 to 50%. Conclusions The data suggest, but do not prove, that preoperative nocturnal oximetry could be a useful preoperative test to identify children who are at increased risk for postoperative respiratory complications.

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Neighbourhood greenness and depression among older adults

The British Journal of Psychiatry ◽

10.1192/bjp.2019.129 ◽

2019 ◽

Vol 215 (2) ◽

pp. 476-480 ◽

Cited By ~ 4

Author(s):

Tatiana Perrino ◽

Joanna Lombard ◽

Tatjana Rundek ◽

Kefeng Wang ◽

Chuanhui Dong ◽

...

Keyword(s):

Older Adults ◽

Odds Ratio ◽

Well Being ◽

Dade County ◽

Depression Diagnosis ◽

Lower Odds ◽

Individual Level ◽

Block Level ◽

Average Block ◽

The Relationship

BackgroundNeighbourhood greenness or vegetative presence has been associated with indicators of health and well-being, but its relationship to depression in older adults has been less studied. Understanding the role of environmental factors in depression may inform and complement traditional depression interventions, including both prevention and treatment.AimsThis study examines the relationship between neighbourhood greenness and depression diagnoses among older adults in Miami-Dade County, Florida, USA.MethodAnalyses examined 249 405 beneficiaries enrolled in Medicare, a USA federal health insurance programme for older adults. Participants were 65 years and older, living in the same Miami location across 2 years (2010–2011). Multilevel analyses assessed the relationship between neighbourhood greenness, assessed by average block-level normalised difference vegetative index via satellite imagery, and depression diagnosis using USA Medicare claims data. Covariates were individual age, gender, race/ethnicity, number of comorbid health conditions and neighbourhood median household income.ResultsOver 9% of beneficiaries had a depression diagnosis. Higher levels of greenness were associated with lower odds of depression, even after adjusting for demographics and health comorbidities. When compared with individuals residing in the lowest tertile of greenness, individuals from the middle tertile (medium greenness) had 8% lower odds of depression (odds ratio 0.92; 95% CI 0.88, 0.96; P = 0.0004) and those from the high tertile (high greenness) had 16% lower odds of depression (odds ratio 0.84; 95% CI 0.79, 0.88; P < 0.0001).ConclusionsHigher levels of greenness may reduce depression odds among older adults. Increasing greenery – even to moderate levels – may enhance individual-level approaches to promoting wellness.Declaration of interestNone.

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A new screening tool for obstructive sleep apnoea tailored to a cardiac population

Journal of Sleep Research ◽

10.1111/jsr.93_12913 ◽

2019 ◽

Vol 28 (S1) ◽

Keyword(s):

Obstructive Sleep Apnoea ◽

Screening Tool ◽

Sleep Apnoea ◽

Obstructive Sleep

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Anosmia as a Screening Tool for COVID-19 Infection: A Prospective Cohort Study

Dubai Medical Journal ◽

10.1159/000517483 ◽

2021 ◽

pp. 1-6

Author(s):

Esra AlHamadani ◽

Sania Zia ◽

Ali AlRahma ◽

Firas AlNajjar

Keyword(s):

Odds Ratio ◽

Screening Tool ◽

Index Finger ◽

Upper Respiratory Tract ◽

Chain Reaction ◽

The Public ◽

Single Center Study ◽

Upper Respiratory ◽

Polymerase Chain ◽

Low Sensitivity

Objectives: Several studies promoted anosmia as a possible isolated symptom for coronavirus disease 2019 (COVID-19). No studies used feasible methods of smell testing that the public would use to address the accuracy of these claims. Methods: This is a single-center study conducted between April 2020 and June 2020. The sense of smell was tested in vitally stable suspected COVID-19 patients with no/mild upper respiratory tract infection symptoms prior to nasopharyngeal swabbing for reverse-transcriptase polymerase chain reaction. Patients were instructed to close their eyes. Each nostril was tested separately while the other was blocked with the patient’s index finger. Patients inhaled from 2 concealed vials (coffee and strawberry essence) consecutively, kept within 30 cm of the nostril for 60 s. Patients who could not identify both odors with both nostrils were recorded as “anosmia.” Results: Out of 346 eligible subjects, 43 had anosmia of which 26 (60%) tested COVID-19 positive. χ2 test showed a p value <0.001. The test showed a sensitivity of 30% (95% confidence interval [CI] 21%, 41%) and specificity 94% (95% CI 90%, 96%). Logistic regression revealed an odds ratio of 5.9 (95% CI 3.0, 12) p value <0.001. Conclusion: Given the low sensitivity (30%) of this method in detecting COVID-19 infection, we conclude that this method is not a useful screening tool for COVID-19 infection. The moderate negative predictive value (80%) is nongeneralizable.

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Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000513411 ◽

2020 ◽

Vol 49 (6) ◽

pp. 611-616

Author(s):

Tarik Qassem ◽

Mohamed S. Khater ◽

Tamer Emara ◽

Doha Rasheedy ◽

Heba M. Tawfik ◽

...

Keyword(s):

Screening Tool ◽

Characteristic Curve ◽

High Sensitivity ◽

Receiver Operator Characteristic Curve ◽

Cutoff Score ◽

Arabic Speakers ◽

Dementia Patients ◽

Significant Difference ◽

Sensitivity Specificity ◽

Addenbrooke’S Cognitive Examination

Background: The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that assesses 5 subdomains of cognition (attention, memory, verbal fluency, visuospatial abilities, and memory recall). It is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. Objectives: We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. Methods: We included 37 patients with dementia (Alzheimer’s disease [n = 25], vascular dementia [n = 8], and dementia with Lewy body [n = 4]) and 43 controls. Results: There was a statistically significant difference (p < 0.001) on the total m-ACE score between dementia patients (mean 10.54 and standard deviation [SD] 5.83) and controls (mean 24.02 and SD 2.75). There was also a statistically significant difference between dementia patients and controls on all sub-score domains of the m-ACE (p < 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cutoff score for dementia on the m-ACE total score was found to be 18 (92% sensitivity, 95% specificity, and 94% accuracy). Conclusions: We adapted the m-ACE in Arabic speakers in Egypt and provided objective validation of it as a screening tool for dementia, with high sensitivity, specificity, and accuracy.

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Developing of a Simple Screening Tool for Opportunistic COPD Case Finding

QJM ◽

10.1093/qjmed/hcaa042.007 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

Y M Mohamed ◽

S H Sharkawy ◽

D I Darwish

Keyword(s):

High Risk ◽

Early Detection ◽

Early Diagnosis ◽

Outpatient Clinic ◽

World Wide ◽

Screening Tool ◽

Case Finding ◽

Screening Questionnaire ◽

Risk Patients ◽

Simple Screening

Abstract Background Under diagnosis of COPD is serious problem in many countries world-wide because there are no generally detection tools available to detect high-risk patients for spirometry, and patients will not go for COPD check-up until a serious issue happens like exacerbation. Objective The aim of the work is trying to assess a new screening tool for early diagnosis of COPD. Patients and Methods The present study was conducted upon 500 subjects during the period from march 2018 to august 2018 who admitted to our chest department or visit our outpatient clinic, employees and visitors to Ain Sham hospitals.All subjects >40yrs who smoker or ex-smoker(≥10pack-years) applied a six variants(age,sex,packed years smoked during life ,dyspnea,chronic phlegmand chronic cohgh)questionnaire modified from PUMA questionnaire Subjects with score ≥5 did spirometry Results 500 subjects shared in the study 497 of them were males ( 99.4% )and 3 were females (.6%). 152of them(30.4%) had score <5 and 348 of them (69.6%)had score ≥5 who did spirometry.152 subjects did not perform spirometry. By spirometry we diagnosed 81(23.3) case COPD (fev1-fvc <.7) out of 348 subjects under gone spirometry and 16.2% of total subjects(500) . Conclusion Modified puma score is a simple and easy screening questionnaire for early detection of COPD cases and spirometry should be done to confirm the diagnosis or rule out.COPD is prevalent in many healthy apparent persons.

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