Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
J Clin Sleep Med. 2021 Mar 1;17(3):521-532. doi: 10.5664/jcsm.8940.
The STOP-Bang questionnaire is a concise and easy screening tool for obstructive sleep apnea (OSA). Using modified body mass index (BMI), we assessed the diagnostic performance of the STOP-Bang questionnaire in predicting OSA in ethnically different groups of patients undergoing surgery.
This was a multicenter prospective cohort study involving patients with cardiovascular risk factors who were undergoing major noncardiac surgery. Patients underwent home sleep apnea testing. All patients completed the STOP-Bang questionnaire. The predictive parameters of STOP-Bang scores were calculated against the apnea-hypopnea index.
From 4 ethnic groups 1,205 patients (666 Chinese, 161 Indian, 195 Malay, and 183 Caucasian) were included in the study. The mean BMI ranged from 25 ± 4 to 30 ± 6 kg/m² and mean age ranged from 64 ± 8 to 71 ± 10 years. For the Chinese and Indian patients, diagnostic parameters are presented using BMI threshold of 27.5 kg/m² with the area under curve to predict moderate-to-severe OSA being 0.709 (0.665-0.753) and 0.722 (0.635-0.808), respectively. For the Malay and Caucasian, diagnostic parameters are presented using BMI threshold of 35 kg/m² with the area under curve for predicting moderate-to-severe OSA being 0.645 (0.572-0.720) and 0.657 (0.578-0.736), respectively. Balancing the sensitivity and specificity, the optimal STOP-Bang thresholds for the Chinese, Indian, Malay, and Caucasian groups were determined to be 4 or greater.
For predicting moderate-to-severe OSA, we recommend BMI threshold of 27.5 kg/m² for Chinese and Indian patients and 35 kg/m² for Malay and Caucasian patients. The optimal STOP-Bang threshold for the Chinese, Indian, Malay and Caucasian groups is 4 or greater.
Registry: ClinicalTrials.gov; Name: Postoperative Vascular Events in Unrecognized Obstructive Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/study/NCT01494181; Identifier: NCT01494181.
STOP-Bang 问卷是阻塞性睡眠呼吸暂停（OSA）的一种简洁易用的筛查工具。我们使用改良的体重指数（BMI）评估了 STOP-Bang 问卷在预测不同种族手术患者 OSA 中的诊断性能。
这是一项多中心前瞻性队列研究，纳入了患有心血管危险因素并接受非心脏大手术的患者。患者进行了家庭睡眠呼吸暂停测试。所有患者均完成了 STOP-Bang 问卷。根据呼吸暂停低通气指数计算 STOP-Bang 评分的预测参数。
从 4 个种族组共纳入 1205 名患者（666 名中国人、161 名印度人、195 名马来人和 183 名白种人）。BMI 均值范围为 25 ± 4 至 30 ± 6 kg/m²，年龄均值范围为 64 ± 8 至 71 ± 10 岁。对于中国人和印度人患者，使用 BMI 阈值 27.5 kg/m² 呈现诊断参数，预测中重度 OSA 的曲线下面积分别为 0.709（0.665-0.753）和 0.722（0.635-0.808）。对于马来人和白种人患者，使用 BMI 阈值 35 kg/m² 呈现诊断参数，预测中重度 OSA 的曲线下面积分别为 0.645（0.572-0.720）和 0.657（0.578-0.736）。平衡敏感性和特异性，确定中国人、印度人、马来人和白种人组的最佳 STOP-Bang 阈值为 4 或更高。
对于预测中重度 OSA，我们建议中国人和印度患者使用 BMI 阈值 27.5 kg/m²，马来人和白种人患者使用 BMI 阈值 35 kg/m²。中国人、印度人、马来人和白种人组的最佳 STOP-Bang 阈值为 4 或更高。
注册处：ClinicalTrials.gov；名称：未识别的阻塞性睡眠呼吸暂停术后血管事件；网址：https://clinicaltrials.gov/ct2/show/study/NCT01494181；标识符：NCT01494181。
