Modified mallampati score – Does it predict more than a difficult airway? A community-based study assessing the association between modified mallampati score and obstructive sleep apnea

Background and Aims: The suspicion of obstructive sleep apnea (OSA) has serious implications for an anesthesiologist perioperatively. This study examines the association between the modified Mallampati scoring (MMS) and the STOP-BANG score in a community setting. Materials and Methods: This was a community-based cross-sectional survey among 702 adults in a rural area in South India. Airway assessment using MMS and assessment for OSA using STOP-BANG scoring were made by junior doctors trained in the anesthesia department. The association between the Mallampati score and the STOP-BANG score was tested by the Chi-square test using the SPSS version 21. Results: Among the community-dwelling adults, 19.2% had a score of 1, 27.9% had a score of 2, 31.3% had a score of 3, and 21.5% had a score of 4 on the Mallampati scoring system. Using the STOP-BANG score for risk stratification of OSA, 29.2% had an intermediate risk and 5.8% had a high risk for OSA. Higher Mallampati Grades (3 and 4) were a significant risk factor for OSA (61.8% vs. 38.2%, P = 0.001). Conclusion: A higher Mallampati class (3 or 4) is significantly associated with an intermediate-to high risk for OSA as assessed using STOP-BANG score criteria. Therefore, we suggest using the MMS not only as an airway screening tool but also as a predictor of OSA, in view of the rising obesity rates in India.