Predictive performance of a multivariable difficult intubation model for obese patients
| Autor: | Chayanan Thanakiattiwibun, Patcharee Maboonyanon, Subongkot Kueprakone, Suthasinee Samankatiwat, Chulaluk Komoltri, Arunotai Siriussawakul |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Multivariate statistics Multivariate analysis medicine.medical_treatment lcsh:Medicine Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Internal medicine Preoperative Care medicine Intubation Intratracheal Intubation Humans 030212 general & internal medicine Obesity Prospective Studies lcsh:Science Multidisciplinary Receiver operating characteristic business.industry lcsh:R Middle Aged Prognosis Thyromental distance Confidence interval Elective Surgical Procedures Multivariate Analysis lcsh:Q Female Airway business Body mass index |
| Zdroj: | PLoS ONE, Vol 13, Iss 8, p e0203142 (2018) |
| ISSN: | 1932-6203 |
| Popis: | Background A predictive model of scores of difficult intubation (DI) may help physicians screen for airway difficulty to reduce morbidity and mortality in obese patients. The present study aimed to set up and evaluate the predictive performance of a newly developed, practical, multivariate DI model for obese patients. Methods A prospective multi-center study was undertaken on adults with a body mass index (BMI) of 30 kg/m2 or more who were undergoing conventional endotracheal intubation. The BMI and 10 preoperative airway tests (namely, malformation of the teeth in the upper jaw, the modified Mallampati test [MMT], the upper lip bite test, neck mobility testing, the neck circumference [NC], the length of the neck, the interincisor gap, the hyomental distance, the thyromental distance [TM] and the sternomental distance) were examined. A DI was defined as one with an intubation difficulty scale (IDS) score ≥ 5. Results The 1,015 patients recruited for the study had a mean BMI of 34.2 (standard deviation: 4.3 kg/m2). The proportions for easy intubation, slight DI and DI were 81%, 15.8% and 3.2%, respectively. Drawing on the results of a multivariate analysis, clinically meaningful variables related to obesity (namely, BMI, MMT, and the ratio of NC to TM) were used to build a predictive model for DI. Nevertheless, the best model only had a fair predictive performance. The area under the receiver operating characteristic curve (AUC) was 0.71 (95% confidence interval 0.68–0.84). Conclusions The predictive performance of the selected model showed limited benefit for preoperative screening to predict DI among obese patients. |
| Databáze: | OpenAIRE |
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