Assessment of STOP-Bang Test Ability to Predict Postoperative Respiratory and Airway Complications of Supratentorial Craniotomy

Abstract

Background: Sleep apnea is a commonly undiagnosed condition that can have serious consequences. The STOP-Bang Questionnaire is a well-recognized screening tool for obstructive sleep apnea (OSA) and is utilized to diagnose OSA in both medical and surgical patients. Objectives: The recent study aimed to assess the effectiveness of the STOP-Bang Questionnaire in predicting postoperative airway and respiratory complications and difficulty in intubation in supratentorial craniotomy. Methods: This cohort study involved 200 patients being considered for supratentorial craniotomy surgery and were referred between July 2019 and September 2020. The STOP-Bang Questionnaire was completed before the operation or during the visit to the anesthesia clinic. The Mallampati score was assessed by examining the patient's demographic characteristics, Body Mass Index (BMI), neck and waist size, underlying disease, and airway. Based on the STOP-Bang scoring system, the patients were divided into low-risk (score less than 3) and high-risk (score greater than or equal to 3). The data were analyzed using SPSS software version 20. Results: Out of all the patients, 125 (62.5%) were deemed low risk, while 75 (37.5%) were classified as high risk. There was no significant difference between the two groups regarding gender (P = 0.108). However, the high-risk group had a higher prevalence of BMI over 35 kg/m2, age over 50 years, and Mallampati III or IV (29.3% vs. 6.4%). Smoking was also more common in the high-risk group (29.3% vs. 16.8%). Patients in the high-risk group experienced a significantly higher frequency of airway obstruction, re-intubation, hypoxia, and longer hospital stays in both the recovery and the intensive care unit (ICU). The ROC curve for airway obstruction intervention indicated a 70.2% level (95% confidence interval: 79.6 - 6.7). The STOP-Bang score was a good predictor for the need for nasal or oral airway implantation, re-intubation, hypoxia, hypotension of arterial blood, and difficulty breathing or speaking. A score higher than two showed the predictive power for all evaluated outcomes. Conclusions: According to our research, patients scoring three or higher on the STOP-Bang test are more likely to experience premature respiratory and airway complications after supratentorial craniotomy surgery. This test can effectively detect adverse complications post-surgery.