Shin et al reported the Score for Preoperative Prediction of Obstructive Sleep Apnea (SPOSA). A patient at risk for obstructive sleep apnea (OSA) is at increased risk for postoperative respiratory complications. The authors are from Massachusetts General Hospital.
Patient selection: surgical patient 18 to 80 years of age, general anesthesia
Parameters:
(1) gender
(2) body mass index (BMI) in kg per square meter
(3) age in years
(4) ASA class from 1 to 4 (ASA 5 rare in population)
(5) arterial hypertension
(6) atrial fibrillation
(7) chronic pulmonary disease
(8) congestive heart failure
(9) diabetes
(10) dyslipidemia
(11) hemiplegia or paraplegia
(12) liver disease
(13) pulmonary hypertension
(14) coronary artery disease
|
Parameter |
Finding |
Points |
|
gender |
female |
0 |
|
|
male |
1 |
|
BMI |
< 25 |
0 |
|
|
25 to 29.9 |
4 |
|
|
30 to 34.9 |
8 |
|
|
>= 35 |
12 |
|
age in years |
18 to 49.99 |
7 |
|
|
50 to 69.99 |
5 |
|
|
70 to 80 |
2 |
|
ASA |
1 |
0 |
|
|
2 |
6 |
|
|
3 |
7 |
|
|
4 |
4 |
|
arterial hypertension |
no |
0 |
|
|
yes |
3 |
|
atrial fibrillation |
no |
0 |
|
|
yes |
2 |
|
chronic pulmonary disease |
no |
0 |
|
|
yes |
3 |
|
congestive heart failure |
no |
0 |
|
|
yes |
2 |
|
diabetes |
no |
0 |
|
|
yes |
1 |
|
dyslipidemia |
no |
0 |
|
|
yes |
4 |
|
hemiplegia or paraplegia |
no |
0 |
|
|
yes |
2 |
|
liver disease |
no |
0 |
|
|
yes |
4 |
|
pulmonary hypertension |
no |
0 |
|
|
yes |
3 |
|
coronary artery disease |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all parameters)
Interpretation:
• minimum score: 2
• maximum score: 52
• The higher the score the greater the risk for OSA.
|
Total Score |
Risk OSA |
|
<= 16 |
low |
|
17 to 23 |
moderate |
|
>= 24 |
high |
Performance:
• The area under the ROC curve was 0.82.
Specialty: Pulmonology
