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STBUR: Sleep trouble breathing and unrefreshed questionnaire: Evaluation of screening tool for postanesthesia care

Jorge A Galvez1,2, Miguel Yaport2, Susan Maeder-Chieffo1

  • 1Department of Anesthesiology & Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Paediatric Anaesthesia
|May 25, 2019
PubMed

Insights

The Snoring, Trouble Breathing, and Un-Refreshed (STBUR) questionnaire effectively identifies children at risk for postoperative breathing issues. Its high negative predictive value suggests it can reliably screen out low-risk patients, improving perioperative care.

Area of Science:

  • Pediatric Anesthesiology
  • Sleep Medicine
  • Respiratory Care

Background:

  • Pediatric sleep-disordered breathing (SDB) poses risks for perioperative adverse events.
  • Limited screening tools exist for preoperative SDB risk assessment in children.
  • The Snoring, Trouble Breathing, and Un-Refreshed (STBUR) questionnaire is a potential screening tool.

Purpose of the Study:

  • To evaluate the STBUR questionnaire's performance in identifying children at risk for postanesthesia adverse events.
  • To assess the questionnaire's utility as a preoperative risk-stratification tool.
  • To determine the questionnaire's predictive value for specific postanesthesia complications.

Main Methods:

  • Retrospective study analyzing data from 6025 patients who completed the STBUR questionnaire.
  • Two screening thresholds (low: scores 1-5; high: score 5) were used.
  • Primary outcomes included supplemental oxygen therapy, prolonged PACU recovery, anesthesia emergency activation, and unplanned hospital admission.

Main Results:

  • The low threshold score showed significant associations with supplemental oxygen therapy (NPV 0.97), prolonged PACU recovery (NPV 0.99), and escalation of care (NPV 0.98).
  • Positive predictive values were significant for all outcomes except anesthesia emergencies.
  • The questionnaire demonstrated high negative predictive values and specificity.

Conclusions:

  • The STBUR questionnaire effectively identifies children at increased risk for prolonged recovery, oxygen needs, and escalated care post-anesthesia.
  • Its high negative predictive value and specificity suggest utility in screening for low-risk patients, potentially optimizing PACU resource allocation.
Abstract

Keywords:
adverse eventscomplicationsobstructive sleep apneaotolaryngologypostanesthesia care unitrespiration

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