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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

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Front. Med.    2018, Vol. 12 Issue (2) : 189-195    https://doi.org/10.1007/s11684-017-0533-8
RESEARCH ARTICLE
Identification of surgical patients at high risk of OSAS using the Berlin Questionnaire to detect potential high risk of adverse respiratory events in post anesthesia care unit
Fei Liu1, Li Liu2, Fang Zheng3, Xiangdong Tang4(), Yongxin Bao5, Yunxia Zuo1()
1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China
2. School of Computing, Chongqing University, Chongqing 400044, China
3. School of Information Science & Engineering, Lanzhou University, Lanzhou 730000, China
4. Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, China
5. Qingdao Women’s and Children’s Hospital, Qingdao 266000, China
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Abstract

Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific. Furthermore, the incidence of adverse respiratory events in the PACU was higher in patients with high risk of OSAS than others (6.8% vs. 0.9%, P<0.001). They also stayed longer than others in the PACU (95±28 min vs. 62±19 min, P <0.001). Age, high risk for OSAS, and smoking were independent risk factors for the occurrence of adverse respiratory events in the PACU. The BQ may be adopted as a screening tool for anesthesiologists in China to identify patients who are at high risk of OSAS and determine the potential risk of developing postoperative respiratory complications in the PACU.
Keywords obstructive sleep apnea      Berlin Questionnaire      Chinese surgical patients      adverse respiratory event     
Corresponding Author(s): Xiangdong Tang,Yunxia Zuo   
Just Accepted Date: 10 May 2017   Online First Date: 07 June 2017    Issue Date: 02 April 2018
 Cite this article:   
Fei Liu,Li Liu,Fang Zheng, et al. Identification of surgical patients at high risk of OSAS using the Berlin Questionnaire to detect potential high risk of adverse respiratory events in post anesthesia care unit[J]. Front. Med., 2018, 12(2): 189-195.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0533-8
https://academic.hep.com.cn/fmd/EN/Y2018/V12/I2/189
High risk (total=125) Low risk (total=967) P value
Male, n (%) 81 (12.8%) 551 (87.2%) 0.096
Female, n (%) 44 (9.6%) 416 (93.4%)
BMI (kg/m2) 24.9±3.9 (15.6–36.7) 22.2±3.2 (14.1–37.8) <0.0005
Overweight (BMI≥25 kg/m2) , n (%) 49 (39.2%) 161 (16.6%) <0.0005
Age (year) 61.1±12.2 (22–90) 51.9±14.4 (18–104) <0.0005
Smoking, n (%) 36 (28.8%) 287 (29.7%) 0.839
Diabetes, n (%) 11 (8.8%) 65 (6.7%) 0.390
Duration of surgery (d) 98±76 110±84 0.628
Type of surgery
General, n (%) 57 (11.4%) 442 (88.6%) 0.360
Thoracic, n (%) 30 (13.1%) 199 (86.9%)
Orthopedics, n (%) 15 (7.7%) 179 (92.3%)
Otolaryngology, n (%) 9 (17.3%) 43 (82.7%)
Urology, n (%) 10 (13.3%) 65 (86.7%)
Neurology, n (%) 4 (9.3%) 39 (90.7%)
Tab.1  Demographic characteristics of the respondents
Female Male P value
Age (year) 61.2±9.9 61.1±13.2 0.988
BMI (kg/m2) 25.8±4.4 24.4±3.6 0.07
Hypertension, n (%) 28 (64%) 67 (82.7%) 0.017
Smoking, n (%) 2 (4.5%) 34 (42%) 0
Diabetes, n (%) 4 (9.1%) 7 (8.6%) 0.933
Tab.2  Comparison of age, BMI, prevalence of hypertension, smoking, and diabetes in the high-risk group between the female and male patients
Fig.1  Prevalence of patients at high risk of OSAS with different ages and sex groups. The prevalence was more remarkable in male patients than that in female patients in the age group of younger than 50 years. However, the number decreased among the male patients in the age group between 50 years old and 70 years old. For the patients aged>70 years, the prevalence among men was higher than among women. * Prevalence of high risk OSAS among male patients was significantly higher than that among female patients in the age group of<40 , 41–50, and>70 years (P<0.05, Chi-Square test). By contrast, the prevalence of high risk OSAS among female patients was significantly higher than that in male patients in the age group of 51–60 and 61–70 years (P<0.05).
Fig.2  Prevalence of high risk in categories I and II, BMI, and hypertension stratified by age. The distribution of high risk in CA1 and CA2 varied in different age groups in both genders. The BMI increased with age for the female patients 40–70 years old, whereas for the male patient solder than 50 years. The prevalence of hypertension also increased with age in both genders. § P<0.05; Chi-Square test for prevalence of CA1, CA2, and hypertension; t-test for BMI.
Factor Estimate Standard error OR P value
Age>60 years old 0.563 0.321 1.862 0.012
Smoking 0.792 0.436 2.058 0.003
High risk for OSA 0.948 0.217 1.407 0.024
Tab.3  Multiple logistic regression for risk factors of adverse respiratory events in the postanesthesia care unit
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