Assessment of STOP-Bang test ability to predict postoperative complications of supratentorial craniotomy

Abstract

Background: Sleep apnea is usually associated with negative outcomes and underdiagnoses. STOP-Bang Questionnaire is a screening method for obstructive sleep apnea (OSA) that is recognized for the diagnosis of OSA in surgical and medical patients. This cross-sectional study aimed to evaluate the ability of the STOP-Bang test to predict complications after supratentorial craniotomy. Methods: In a cross-sectional study, 200 patients who were candidates for supratentorial craniotomy surgery who were referred to Loghman Hospital from July 2019 to September 2020 were included in the study. The STOP-Bang questionnaire was completed the day before the operation or during the visit to the anesthesia clinic. Demographic characteristics, body mass index (BMI), neck and waist size, underlying disease, and airway examination were performed to assess the Mallampati score for patients. According to the STOP-Bang scoring system, patients were categorized into two groups: low risk (score less than 3) and high risk (score higher or equal to 3). Data were analyzed using SPSS software version 20. Results: A total of 125 patients (62.5%) were low risk and 75 patients (37.5%) were high-risk. There was no statistically significant difference between the two groups of patients in terms of gender (P = 0.108). BMI over 35 kg / m2 and age over 50 years were higher in the high-risk group. The incidence of Malampati III or IV was higher in the high-risk group (29.3 vs. 6.4%). Smoking was higher in the high-risk group (29.3 vs. 16.8%). The frequency of airway obstruction, re-intubation, hypoxia, and length of hospitalization in recovery, and in the intensive care unit was significantly higher in the high-risk group. The level of the ROC curve for airway obstruction required intervention equal to 70.2% (95% confidence interval: 79.6-6.7). STOP-Bang showed good predictive power (Diagnostic power> 50percentage) for the need for nasal or oral airway implantation, re-intubation, hypoxia and hypotension of arterial blood, and difficulty in breathing or speaking. A score higher than two showed the predictive power of all evaluated outcomes. Conclusion: Our findings showed that the occurrence of premature respiratory complications after supratentorial craniotomy surgery is more common in patients with a screening score of three or higher on the STOP-Bang test, and this test can detect adverse complications after surgery.