STOP-BANG questionnaire identifies patients with OSA at hight risk for surgical complications

What is preoperative STOP-BANG?

This is a questionnaire that evaluates the following patient characteristics:

Snoring, Tiredness during daytime, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, Gender

Patient population

135 adult patients undergoing elective surgery at a tertiary care center were administered the STOP-BANG questionnaire.

41.5% of patients had high risk scores for OSAS.

Patients at high risk of OSAS had a much higher rate of postoperative complications compared with patients at low risk (19.6% vs 1.3%).

STOP-BANG questionnaire predicts high risk

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.

References

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

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Celiprolol as treatment of choice to prevent complications in vascular Ehlers-Danlos syndrome

Vascular Ehlers-Danlos syndrome is a rare hereditary connective tissue disorder caused by mutations in the collagen type III gene ( COL3A1 ), which leads to a loss of tissue integrity in many organ systems.

Patients with vascular Ehlers-Danlos syndrome have weakened blood vessels and an increased risk of arterial dissection or rupture that can lead to early death.

The researchers assessed the ability of celiprolol, a β1-adrenoceptor antagonist with a β2-adrenoceptor agonist action, to prevent arterial dissections and ruptures in vascular Ehlers-Danlos syndrome.

Patients with clinical vascular Ehlers-Danlos syndrome were randomly assigned to 5 years of treatment with celiprolol or to no treatment.

33 patients were positive for mutation of collagen 3A1 (COL3A1). Celiprolol was uptitrated every 6 months by steps of 100 mg to a maximum of 400 mg twice daily. The primary endpoints were arterial events (rupture or dissection, fatal or not).

Mean duration of follow-up was 47 months, with the trial stopped early for treatment benefit.

The primary endpoints were reached by 20% in the celiprolol group and by 50% controls (hazard ratio [HR] 0·36).

Celiprolol might be the treatment of choice for physicians aiming to prevent major complications in patients with vascular Ehlers-Danlos syndrome.

References:

Effect of celiprolol on prevention of cardiovascular events in vascular Ehlers-Danlos syndrome: a prospective randomised, open, blinded-endpoints trial. The Lancet, Volume 376, Issue 9751, Pages 1476 - 1484, 30 October 2010.

Celiprolol therapy for vascular Ehlers-Danlos syndrome. The Lancet, Volume 376, Issue 9751, Pages 1443 - 1444, 30 October 2010.