Cited by 571Obstructive Sleep Apnea ResearchAirway Management and Intubation TechniquesCardiac, Anesthesia and Surgical Outcomes

Validation of the Berlin Questionnaire and American Society of Anesthesiologists Checklist as Screening Tools for Obstructive Sleep Apnea in Surgical Patients

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Chung, Frances, Yegneswaran, Balaji, Liao, Pu, Chung, Sharon A., Vairavanathan, Santhira, Islam, Sazzadul, Khajehdehi, Ali, Shapiro, Colin M.·2008·Anesthesiology

Abstract

Background: Because of the high prevalence of obstructive sleep apnea (OSA) and its adverse impact on perioperative outcome, a practical screening tool for surgical patients is required. This study was conducted to validate the Berlin questionnaire and the American Society of Anesthesiologists (ASA) checklist in surgical patients and to compare them with the STOP questionnaire. Methods: After hospital ethics approval, preoperative patients aged 18 yr or older and without previously diagnosed OSA were recruited. The scores from the Berlin questionnaire, ASA checklist, and STOP questionnaire were evaluated versus the apnea-hypopnea index from in-laboratory polysomnography. The perioperative data were collected through chart review. Results: Of 2,467 screened patients, 33, 27, and 28% were respectively classified as being at high risk of OSA by the Berlin questionnaire, ASA checklist, and STOP questionnaire. The performance of the screening tools was evaluated in 177 patients who underwent polysomnography. The sensitivities of the Berlin questionnaire, ASA checklist, and STOP questionnaire were 68.9-87.2, 72.1-87.2, and 65.6-79.5% at different apnea-hypopnea index cutoffs. There was no significant difference between the three screening tools in the predictive parameters. The patients with an apnea-hypopnea index greater than 5 and the patients identified as being at high risk of OSA by the STOP questionnaire or ASA checklist had a significantly increased incidence of postoperative complications. Conclusions: Similar to the STOP questionnaire, the Berlin questionnaire and ASA checklist demonstrated a moderately high level of sensitivity for OSA screening. The STOP questionnaire and the ASA checklist were able to identify the patients who were likely to develop postoperative complications.

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  • The Berlin questionnaire has a sensitivity of 69-87% in surgical patients.

    “Its sensitivity is 69–87% in surgical patients.”

    From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [489]

  • The ASA checklist was validated in a surgical population with moderate sensitivity (72%-87%), comparable to the STOP and Berlin questionnaires.

    “The ASA checklist was validated in surgical population with a moderate sensitivity (72%–87%) which was comparable to both the STOP and Berlin questionnaires.”

    From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [489]

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  1. [8]8. Weinreich G, Plein K, Teschler T, Resler J, Teschler H: Is the Berlin questionnaire an appropriate diagnostic tool for sleep medicine in pneumologi- cal rehabilitation? [in German]. Pneumologie 2006; 60:737-42

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Authors
Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., & Shapiro, C. M.
Affiliations
  • Professor, Department of Anesthesia.
  • Research Fellow.
  • Research Analyst.
  • University Health Network (CA)
  • Research Coordinator, Department of Anesthesia.
Venue
Anesthesiology
Published
2008-05-01
Volume
108
Issue
5
Pages
822-830
ISSN
0003-3022 (ISSN-L)
OpenAlex
W1970984835
Cited by
571
References
31
Citations by year
2026: 5 · 2025: 11 · 2024: 19 · 2023: 17 · 2022: 27 · 2021: 23 · 2020: 23 · 2019: 23 · 2018: 31 · 2017: 33 · 2016: 42 · 2015: 55 · 2014: 56 · 2013: 52 · 2012: 51
FWCI
22.80
Type
journal article
Language
en
Open access
Locations
  • Anesthesiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Keywords
obstructive sleep apnea, preoperative screening, Berlin questionnaire, STOP questionnaire, apnea-hypopnea index, polysomnography, diagnostic sensitivity, postoperative complications, surgical patients
MeSH terms
Adult, Aged, Anesthesiology, Berlin, Female, Humans, Male, Predictive Value of Tests, Surveys and Questionnaires, Sensitivity and Specificity, Societies, Medical, Surgical Procedures, Operative, United States, Reproducibility of Results, Body Mass Index, Prevalence, Sleep Apnea, Obstructive

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