Predictive value of bedside tests for difficult intubations

S. Aktas, Y.O. Atalay, M. Tugrul

Department of Anaesthesiology, The Private Emsey Hospital, Istanbul, Turkey. yunus.atalay76@gmail.com

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• Anesthesiology

OBJECTIVE: The aim of this study is to find the ideal test(s) for the prediction of difficult laryngoscopic intubation.

PATIENTS AND METHODS: One hundred and twenty patients were selected at random for this prospective observational study. The patients’ preoperative exams include the assessment of Mallampati classification, thyromental, sternomental, interincisor distances and neck circumference. The laryngoscopy was evaluated with using the Cormack Lehane classification. The sensitivity, specificity, positive and negative predictive values and accuracy of tests, alone and in combination, were assessed.

RESULTS: No statistically significant difference was found between the difficult and easy intubation cases. Sternomental distance showed the highest sensitivity (76%) and positive predictor value (54%). As the critical value of neck circumference was set to 35 cm and above, the sensitivity was 74% and positive predictive value, 53%. For the neck circumference and sternomental distance combination, which is determined to be the most reliable and accurate criteria, the sensitivity was 62% and positive predictive value, 42%.

CONCLUSIONS: The findings suggest that the sternomental distance and neck circumference combination may be a more accurate predictor of difficult intubation.

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