Evaluation of bedside tests and proposal of a model for predicting difficult laryngoscopy: an observational prospective study☆

Autor: Chara Liaskou, Eleftherios Vouzounerakis, Anastasia Trikoupi, Chryssoula Staikou
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Brazilian Journal of Anesthesiology, Vol 70, Iss 2, Pp 125-133 (2020)
Druh dokumentu: article
ISSN: 0104-0014
DOI: 10.1016/j.bjane.2020.04.021
Popis: Background and objectives: The prediction of difficult laryngoscopy is based on tests that assess anatomic characteristics of face and neck. We aimed to identify the most accurate tests and propose a multivariate predictive model. Methods: This prospective observational study included 1134 patients. Thyromental Distance (TMD), Sternomental Distance (STMD), Ratio of Height-to-Thyromental Distance (R-H/TMD), Neck Circumference (NC), Ratio of Neck Circumference-to-Thyromental Distance (R-NC/TMD), Hyomental Distance with head in Neutral Position (HMD-NP) and at Maximal Extension (HMD-HE), Ratio of Hyomental Distance at Maximal head extension-to-hyomental distance in neutral position (R-HMD), Mallampati Class (MLC), Upper Lip Bite Test (ULBT), Mouth Opening (MO) and Head Extension (HE) were assessed preoperatively. A Cormack-Lehane Grade ≥ 3 was defined as Difficult Laryngoscopy. Sensitivity, specificity, positive and negative predictive values were assessed for all tests. Multivariate analysis with logistic regression was used to create the predictive models. Results: A model incorporating MLC, ULBT, HE, HMD-HE and R-NC/TMD showed high prognostic accuracy; x2(5) = 109.12, p
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