Comparison of nosas score with stop-bang and Berlin scores in predicting difficult airway

Preoperative evaluation of the airway of patients scheduled for surgery is of great importance because difficult airway management is the most common cause of anesthesia-related morbidity and mortality. There are several factors that can predict potential difficulty in mask ventilation and endotracheal intubation. OSAS is one of these factors. Our aim was to compare the efficacy of NoSAS, STOP-Bang and Berlin scoring in predicting difficult airway and to determine which of these scoring is more usable and effective in predicting difficult airway. NoSAS, STOP-Bang and Berlin scores were calculated preoperatively in 420 patients aged 18 years and older who were planned for elective surgery and orotracheal intubation with ethics committee approval. In the operation room, mask ventilation and intubation of the patients were performed by research assistants with 2 years or more experience. Demographic information of the patients, neck circumference, OSAS diagnosis, history of difficult intubation, comorbidities, ASA score, mallampati and Cormack-Lehane degrees were examined and recorded in detail and the success of these three tests in predicting difficult intubation and difficult mask ventilation were compared. Of the patients who participated in our study, 83 (%19,8) were evaluated as difficult mask ventilation (V3) and 101 (%24) as difficult intubation (EZS>5). ROC analysis was performed as a result of a statistically significant relationship between the mask ventilation difficulty scale and intubation difficulty scale and all three scoring systems. It was found that the NoSAS score had a higher predictive power than the other scoring systems in predicting difficult mask ventilation and difficult intubation. The cut-off value of the NoSAS score for difficult mask ventilation was 6.5 and the cut-off value for difficult intubation was 7.5. We believe that the NoSAS score, which is an easy-to-use, short and objective scale and was first developed as a simple but effective tool for OSAS screening, will be successful in the preoperative detection of difficult airway in all patients receiving general anesthesia.