A Quality Improvement Project: Using the STOP-BANG Tool in a Military Population to Improve Equity in Preoperative Screening

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The lack of a preoperative screening tool to detect obstructive sleep apnea (OSA) may lead to an increase in postoperative complications.


The aim of the study was to implement a prescreening tool to identify diagnosed or undiagnosed OSA before a surgical procedure.


The study was conducted in the surgical admission center and postanesthesia care unit at a military treatment facility in Hawaii.


Participants of the study included military personnel, military family members, veterans, and veteran beneficiaries.


The STOP-BANG (snore/tired/obstruction/pressure-body mass index/age/neck/gender) tool was used between April and June 2013 to identify and stratify 1,625 patients into low-risk, intermediate-risk, high-risk, and known OSA categories.


The STOP-BANG tool confirmed the diagnosed OSA rate to be 13.48%, and increased at-risk OSA detection by 24.69%. Hawaiians/Pacific Islanders were more frequently found to be at risk with known OSA, likely to have complications, and be transferred to PACU 23-hour extended stay compared to other races and intermediate-risk and high-risk categories.


The STOP-BANG tool identified and stratified surgical patients at risk for OSA and standardized OSA assessments.

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