Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway

Abstract Background This study aimed to compare the effectiveness of the NoSAS, STOP-Bang, and Berlin scoring systems, which are utilized to predict obstructive sleep apnea syndrome (OSAS), in forecasting difficult airway management. Additionally, the study sought to determine which of these scoring...

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Main Authors: Onurcan Balık, Eyyüp Sabri Özden, Mustafa Soner Özcan, Filiz Alkaya Solmaz, Pakize Kırdemir
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s12871-025-02926-1
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author Onurcan Balık
Eyyüp Sabri Özden
Mustafa Soner Özcan
Filiz Alkaya Solmaz
Pakize Kırdemir
author_facet Onurcan Balık
Eyyüp Sabri Özden
Mustafa Soner Özcan
Filiz Alkaya Solmaz
Pakize Kırdemir
author_sort Onurcan Balık
collection DOAJ
description Abstract Background This study aimed to compare the effectiveness of the NoSAS, STOP-Bang, and Berlin scoring systems, which are utilized to predict obstructive sleep apnea syndrome (OSAS), in forecasting difficult airway management. Additionally, the study sought to determine which of these scoring systems is the most practical and effective for this purpose. Methods Following the ethics committee approval, preoperative NoSAS, STOP-Bang, and Berlin scores were calculated for 420 patients aged 18 years and older who were scheduled for tracheal intubation. Mask ventilation and intubation were performed by research assistant with a minimum of two years of experience. Detailed examinations and recordings were conducted, including demographic data, neck circumference, OSAS diagnosis, history of difficult intubation, comorbidities, ASA classification, Mallampati classification, and Cormack-Lehane grade. Subsequently, the predictive efficacy of these three scoring systems for difficult mask ventilation and difficult intubation was compared. Results In our study, 83 patients (19.8%) were classified as having difficult mask ventilation, and 101 patients (24.0%) were classified as having difficult intubation. The NoSAS score demonstrated a higher predictive power compared to the other scoring systems for difficult mask ventilation and difficult intubation. The cut-off value for the NoSAS score was determined to be 6.5 for predicting difficult mask ventilation and 7.5 for predicting difficult intubation. Conclusion The routine implementation of the NoSAS score, an easy-to-use, rapid and objective tool primarily developed for OSAS screening, is likely to be effective in preoperatively identifying difficult airways in patients undergoing general anesthesia.
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spelling doaj-art-91f2452285534dd3bafe09ab4fa54e6a2025-02-02T12:40:01ZengBMCBMC Anesthesiology1471-22532025-01-0125111010.1186/s12871-025-02926-1Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airwayOnurcan Balık0Eyyüp Sabri Özden1Mustafa Soner Özcan2Filiz Alkaya Solmaz3Pakize Kırdemir4Department of Anesthesiology and Reanimation, Faculty of Medicine, Suleyman Demirel UniversityDepartment of Anesthesiology and Reanimation, Faculty of Medicine, Suleyman Demirel UniversityDepartment of Anesthesiology and Reanimation, Faculty of Medicine, Suleyman Demirel UniversityDepartment of Anesthesiology and Reanimation, Faculty of Medicine, Suleyman Demirel UniversityDepartment of Anesthesiology and Reanimation, Faculty of Medicine, Suleyman Demirel UniversityAbstract Background This study aimed to compare the effectiveness of the NoSAS, STOP-Bang, and Berlin scoring systems, which are utilized to predict obstructive sleep apnea syndrome (OSAS), in forecasting difficult airway management. Additionally, the study sought to determine which of these scoring systems is the most practical and effective for this purpose. Methods Following the ethics committee approval, preoperative NoSAS, STOP-Bang, and Berlin scores were calculated for 420 patients aged 18 years and older who were scheduled for tracheal intubation. Mask ventilation and intubation were performed by research assistant with a minimum of two years of experience. Detailed examinations and recordings were conducted, including demographic data, neck circumference, OSAS diagnosis, history of difficult intubation, comorbidities, ASA classification, Mallampati classification, and Cormack-Lehane grade. Subsequently, the predictive efficacy of these three scoring systems for difficult mask ventilation and difficult intubation was compared. Results In our study, 83 patients (19.8%) were classified as having difficult mask ventilation, and 101 patients (24.0%) were classified as having difficult intubation. The NoSAS score demonstrated a higher predictive power compared to the other scoring systems for difficult mask ventilation and difficult intubation. The cut-off value for the NoSAS score was determined to be 6.5 for predicting difficult mask ventilation and 7.5 for predicting difficult intubation. Conclusion The routine implementation of the NoSAS score, an easy-to-use, rapid and objective tool primarily developed for OSAS screening, is likely to be effective in preoperatively identifying difficult airways in patients undergoing general anesthesia.https://doi.org/10.1186/s12871-025-02926-1Berlin scoreDifficult airwayNoSAS scoreSTOP-Bang score
spellingShingle Onurcan Balık
Eyyüp Sabri Özden
Mustafa Soner Özcan
Filiz Alkaya Solmaz
Pakize Kırdemir
Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway
BMC Anesthesiology
Berlin score
Difficult airway
NoSAS score
STOP-Bang score
title Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway
title_full Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway
title_fullStr Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway
title_full_unstemmed Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway
title_short Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway
title_sort comparison of nosas score with stop bang and berlin scores in predicting difficult airway
topic Berlin score
Difficult airway
NoSAS score
STOP-Bang score
url https://doi.org/10.1186/s12871-025-02926-1
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