Cross Sectional Observational Study Performed to See for Relation of Mallampati Score and Extended Mallampati Score with Body Mass Index

Menon, Sasha Maria; Shailaja, S; Mathew, Megha

doi:10.7860/jcdr/2017/23937.9865

Cited by 6 publications

(8 citation statements)

References 22 publications

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“…An extremely important attribute for any test or clinical evaluation is reliability (ie, that independent assessments by qualified observers are likely to obtain the same result). Studies of such interrater reliability have noted Mallampati score agreement in between 42% and 89% of preoperative 21,24,[47][48][49][50][51][52][53] or dental clinic 54 adults (Table). k Statistics fall well short of strong agreement (Table).…”

Section: How Reliable Is the Mallampati Score?mentioning

confidence: 99%

Is the Mallampati Score Useful for Emergency Department Airway Management or Procedural Sedation?

Green

Roback

2019

Annals of Emergency Medicine

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We review the literature in regard to the accuracy, reliability, and feasibility of the Mallampati score as might be pertinent and applicable to emergency department (ED) airway management and procedural sedation. This 4-level pictorial tool was devised to predict difficult preoperative laryngoscopy and intubation, but is now also widely recommended as a routine screening element before procedural sedation. The literature evidence demonstrates that the Mallampati score is inadequately sensitive for the identification of difficult laryngoscopy, difficult intubation, and difficult bag-valve-mask ventilation, with likelihood ratios indicating a small and clinically insignificant effect on outcome prediction. Although it is important to anticipate that patients may have a difficult airway, there is no specific evidence that the Mallampati score augments or improves the baseline clinical judgment of a standard airway evaluation. It generates numerous false-positive warnings for each correct prediction of a difficult airway. The Mallampati score is not reliably assessed because independent observers commonly grade it differently. It cannot be evaluated in many young children and in patients who cannot cooperate because of their underlying medical condition. The Mallampati score lacks the accuracy, reliability, and feasibility required to supplement a standard airway evaluation before ED airway management or procedural sedation. [

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Section: How Reliable Is the Mallampati Score?mentioning

confidence: 99%

Is the Mallampati Score Useful for Emergency Department Airway Management or Procedural Sedation?

Green

Roback

2019

Annals of Emergency Medicine

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“…Conversely, a study was done by Menon et al [32] stated that there is no significant difference between EMS and MMS. The potential limitation in this finding does not correlate with the Cormack-Lehane classification [32]. Despite the studies done by Hanouz et al [33] and Ouchi et al [34], these are not performed solely in obese individuals.…”

Section: Mallampati Scorementioning

confidence: 94%

“…Therefore, studies have recommended the EMS test in the traditional evaluation [11,31]. Conversely, a study was done by Menon et al [32] stated that there is no significant difference between EMS and MMS. The potential limitation in this finding does not correlate with the Cormack-Lehane classification [32].…”

Section: Mallampati Scorementioning

confidence: 99%

Obesity and the Other Independent Predictors in Elective Endotracheal Tube Intubations: A Narrative Review

et al. 2022

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Obesity is one of the challenging elements in health care. Studies have shown that as the body mass index (BMI) increases, the risk of chronic conditions tends to increase due to altered physiologic and metabolic demands. In addition to underlying physiological changes, anatomical changes can lead to common procedural challenges, such as difficult intravenous (IV) cannulation, difficult airway, and difficult intubation, which makes their preoperative and postoperative care challenging for the anesthesiologists. According to previous studies, there is no single best predictor for difficult airway or intubations and no designed protocol for choosing an intubation technique in obese patients. Some of the preoperative risk factors and techniques such as the modified Mallampati class, sternomental distance, thyromental distance, neck circumference, indirect mirror laryngoscopy, BMI, and intraoperative risk factors such as inappropriate positioning of the patient, suboptimal medication dosing, inappropriate laryngoscopy device acted as independent predictors for difficult airway and difficult intubation. Analyzing each element's importance and making suitable decisions for the individual will reduce the complications and prepare for unplanned emergencies in the operating room. This review is convincing with previous studies that obesity itself is not an independent predictor. Instead, as a preoperative risk factor, and till date, sternomental distance and the number of intubation attempts were demonstrated as significant independent predictors for adverse events. All the other independent factors and considerations were discussed, which can help with further research.

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“…In grade III, the soft palate is visible, but the uvula is obscured. 14 MID was recorded by asking the participant to sit upright and open the mouth as wide as possible. 15 The TMD was measured as the straight distance between the thyroid notch and the lower border of the mental prominence, while the head was fully extended, and the mouth closed.…”

Section: Methodsmentioning

confidence: 99%

Moderate to severe OSA screening based on support vector machine of the Chinese population faciocervical measurements dataset: a cross-sectional study

Zhang

Yan

et al. 2021

BMJ Open

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ObjectivesObstructive sleep apnoea (OSA) has received much attention as a risk factor for perioperative complications and 68.5% of OSA patients remain undiagnosed before surgery. Faciocervical characteristics may screen OSA for Asians due to smaller upper airways compared with Caucasians. Thus, our study aimed to explore a machine-learning model to screen moderate to severe OSA based on faciocervical and anthropometric measurements.DesignA cross-sectional study.SettingData were collected from the Shanghai Jiao Tong University School of Medicine affiliated Ruijin Hospital between February 2019 and August 2020.ParticipantsA total of 481 Chinese participants were included in the study.Primary and secondary outcome(1) Identification of moderate to severe OSA with apnoea–hypopnoea index 15 events/hour and (2) Verification of the machine-learning model.ResultsSex-Age-Body mass index (BMI)-maximum Interincisal distance-ratio of Height to thyrosternum distance-neck Circumference-waist Circumference (SABIHC2) model was set up. The SABIHC2 model could screen moderate to severe OSA with an area under the curve (AUC)=0.832, the sensitivity of 0.916 and specificity of 0.749, and performed better than the STOP-BANG (snoring, tiredness, observed apnea, high blood pressure, BMI, age, neck circumference, and male gender) questionnaire, which showed AUC=0.631, the sensitivity of 0.487 and specificity of 0.772. Especially for asymptomatic patients (Epworth Sleepiness Scale <10), the SABIHC2 model demonstrated better predictive ability compared with the STOP-BANG questionnaire, with AUC (0.824 vs 0.530), sensitivity (0.892 vs 0.348) and specificity (0.755 vs 0.809).ConclusionThe SABIHC2 machine-learning model provides a simple and accurate assessment of moderate to severe OSA in the Chinese population, especially for those without significant daytime sleepiness.

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Cross Sectional Observational Study Performed to See for Relation of Mallampati Score and Extended Mallampati Score with Body Mass Index

Abstract: From this study we concluded that there was no difference between the MMS and EMS. There was interobserver agreement between MMS and EMS and a positive correlation of body mass index with MMS and EMS was seen.

Cited by 6 publications

References 22 publications

Is the Mallampati Score Useful for Emergency Department Airway Management or Procedural Sedation?

Is the Mallampati Score Useful for Emergency Department Airway Management or Procedural Sedation?

Obesity and the Other Independent Predictors in Elective Endotracheal Tube Intubations: A Narrative Review

Moderate to severe OSA screening based on support vector machine of the Chinese population faciocervical measurements dataset: a cross-sectional study

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