alexa Preoperative airway assessment: predictive value of a multivariate risk index.


Journal of Anesthesia & Clinical Research

Author(s): elGanzouri AR, McCarthy RJ, Tuman KJ, Tanck EN, Ivankovich AD

Abstract Share this page

Abstract Using readily available and objective airway risk criteria, a multivariate model for stratifying risk of difficult endotracheal intubation was developed and its accuracy compared to currently applied clinical methods. We studied 10,507 consecutive patients who were prospectively assessed prior to general anesthesia with respect to mouth opening, thyromental distance, oropharyngeal (Mallampati) classification, neck movement, ability to prognath, body weight, and history of difficult tracheal intubation. After induction of anesthesia, the laryngeal view during rigid laryngoscopy was graded and the ability of experienced anesthesia personnel to ventilate via a mask was determined. Poor intubating conditions (laryngoscopy Grade IV) and inability to achieve adequate mask ventilation were identified in 107 (1\%) and 8 (0.07\%) cases, respectively. Logistic regression identified all seven criteria as independent predictors of difficulty with laryngoscopic visualization. A composite airway risk index (derived from nominalized odds ratios calculated from the multivariate model) as well a simplified (0 = low, 1 = medium, 2 = high) risk weighting exhibited higher positive predictive value for laryngoscopy Grade IV at scores with similar sensitivity to Mallampati class III, as well as higher sensitivity at scores with similar positive predictive value. Compared to Mallampati class I fewer false-negative predictions were observed at a risk index value of 0. We conclude that improved risk stratification for difficulty with visualization during rigid laryngoscopy (Grade IV) can be obtained by use of a simplified preoperative multivariate airway risk index, with better accuracy compared to oropharyngeal (Mallampati) classification at both low- and high-risk levels.
This article was published in Anesth Analg and referenced in Journal of Anesthesia & Clinical Research

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

1-702-714-7001Extn: 9037

Business & Management Journals


1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

1-702-714-7001Extn: 9042

General Science

Andrea Jason

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

1-702-714-7001Extn: 9042

© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version