Evaluation of the STOP-BANG SCORE as a screening tool to predict the difficult airway

Background: The STOP-BANG (SB) questionnaire is a validated screening tool for obstructive sleep apnea screening and may also serve as a predictor of difficult airway management. However, existing evidence linking SB scores to airway difficulty remains limited and inconsistent. This study addresses this gap by assessing the usefulness of the SB score as a simple, non-invasive preoperative predictor of difficult airway management. Method: A qualitative observational study was conducted involving 250 patients aged 25–65 years (American Society of Anesthesiologists [ASA] physical status I–III) undergoing elective surgery under general anesthesia with endotracheal intubation. Each patient’s SB score was recorded preoperatively. Patients were then divided into two groups: Group I (SB score <3) and Group II (SB score ≥3). After induction of anesthesia, airway parameters were assessed, including mask ventilation grade, Cormack–Lehane (CL) laryngoscopic view, and the intubation difficulty scale (IDS) score. Results: The mean age was 42.4 ± 13.9 years. In Group I, the mean weight and height were 60.9 ± 8.9 kg and 1.58 ± 0.07 m, respectively, while in Group II, they were 73.1 ± 8.9 kg and 1.61 ± 0.10 m, respectively (p < 0.05). Mask ventilation was easier in Group I, with 54.2% of patients exhibiting grade 1 ventilation, whereas 48.9% of patients in Group II had grade 3 ventilation. Slight intubation difficulty (IDS 1–5) was more frequent in Group II. Higher SB scores were also associated with poorer CL grades. Conclusion: An SB score ≥3 effectively predicts difficult airway management, being associated with higher rates of difficult mask ventilation, poorer laryngoscopic views, and increased IDS. As a quick, reliable, and non-invasive tool, SB can help anesthesiologists anticipate airway challenges and enhance perioperative safety.