Evaluation of the relationship between postoperative complications by determining the risk of sleep apne with the stop-bang scores of patients in general anesthesia

Patients with Obstructive Sleep Apnea Syndrome (OSAS), which have been shown to be closely associated with perioperative complications, are often encountered undiagnosed before anesthesia. Although the gold standard is the polysomnography in diagnosis, its use is limited due to its labor intensive, cost and time consuming. In our study; We aimed to demonstrate the usefulness of STOP-Bang questionnaire application in surgical patients in the preoperative period in the diagnosis of OSAS and difficult airway / complication prediction. Our prospective study was performed on 1000 randomly-consecutive patients, ≥18 years, to be intubated under general anesthesia for elective surgery. The patients were divided into low, medium and high risk groups with the STOP-Bang questionnaire consisting of two steps and eight questions. Demographic data, anesthesia-airway features, peroperative complications, duration of stay in the recovery unit and unplanned intensive care unit (ICU) requirements were recorded. The rates of difficult mask ventilation/intubation, peroperative complication and unplanned ICU requirement and durations of the recovery unite were found to be significantly higher in the high and medium risk groups compared to the low risk group and in the high risk group compared to the medium risk group (p˂0.001 for all variables). Diagnostic performance in determining difficult airway and postoperative complications in patients at high risk for OSAS with the STOP-Bang survey; respectively, sensitivity was 77.9% for difficult intubation, specificity was 87.4%, positive predictive value (PPV) was 28.0%, and sensitivity for postoperative pulmonary complication was 71.0%, and specificity was 88.0%, PPV was 32.9%. In our large patient series study; according to the STOP-Bang survey, patients with moderate and high risk for OSAS were closely associated with difficult mask ventilation / intubation and postoperative complications. We believe that with the preoperative STOP-Bang survey application, determining the possible OSAS diagnosis and risk level will be beneficial for anesthesia management.