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A2761 - Associations Between STOP-Bang Scores and COPD Exacerbations
Author Block: K. Ma, K. Patel, J. Gordon, D. A. Shade, T. J. Cheema, A. Singh; Pulmonary Critical Care, Allegheny General Hospital, Pittsburgh, PA, United States.
Rationale: Exacerbations from chronic obstructive pulmonary disease (COPD) are a common cause for hospital admissions, necessitating increasing demands in hospital resources and costs . COPD is the third leading cause of death in the United States. A frequent comorbidity that coexists with COPD is obstructive sleep apnea (OSA). Overlap syndrome is diagnosed if both are concurrently seen in the same patient and is present in 10-30% of COPD patients . The presence of overlap syndrome is associated with increasing hospitalizations from COPD exacerbations (AECOPD) and increasing all-cause mortality compared to those with just COPD alone. Patients with overlap syndrome tend to have more hypoxemic and hypercapnic episodes than patients with OSA alone. This could potentially complicate AECOPD hospitalizations and prompt readmissions. The STOP-Bang questionnaire is a screening tool to assess a patient’s risk for OSA with high sensitivity. A score of 3 or higher is intermediate or high risk for OSA. For this study, we looked at whether STOP-Bang scores have an association with length of stay (LOS) and previous AECOPD episodes within the last year. Methods: We identified 305 patients with who were admitted between July 2014 and Sept 2016 for COPD exacerbations. The STOP- Bang questionnaire was conducted for each patient during their admission irrespective of whether they have an OSA diagnosis. Patients were categorized into two groups, Stop-Bang scores of 2 or less and those with a score of 3 or higher. The objectives of this retrospective study are to assess LOS and prior AECOPD hospitalizations within the last year between these two groups. The study population included patients with all COPD severities based on the global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Results: The results showed that there was no major difference in the length of stay between the two groups (see table). However, patients with a STOP-Bang score of 3 or higher were associated with significantly higher rates of AECOPD episodes requiring hospitalization within the previous 12 months. Out of the 96 patients with readmissions, 74 patients had a STOP-Bang of 3 or higher. Conclusions: Previous studies have shown worsening outcomes and mortality for patients with overlap syndrome. Increasing early recognition of overlap syndrome can lead to timely OSA diagnosis and treatment. This may decrease AECOPD readmission rates along with medical costs. Implementing the STOP-Bang questionnaire to COPD patients on admission is critical to this early recognition.