Screening Tests for Predicting Difficult Intubation. A Clinical Assessment in Turkish Patients

Abstract

Three methods of predicting difficult intubation were compared prospectively. Mallampati test, Wilson risk-sum and thyromental distance were determined preoperatively and laryngeal views were graded in 500 patients. The sensitivities, specificities, positive and negative predictive values of each test were calculated. The incidence of difficult intubation was found to be 8%. The sensitivities of the Mallampati test, the Wilson risk-sum and the thyromental distance were 43%, 58% and 35% respectively, and the specificities were 93%, 91% and 95% respectively. Significant differences were seen between the sensitivities of the Mallampati test and the Wilson risk-sum (P<0.001), the Wilson risk-sum and the thyromental distance (P<0.001), the Mallampati test and the thyromental distance (P<0.05). Among the different specificities, the only significant difference was observed between the Wilson risk-sum and the thyromental distance (P<0.05). There were no significant differences between the positive and negative predictive values of the three screening tests (P>0.05). In conclusion, the Wilson risk-sum was the most sensitive test and the thyromental distance has the highest positive predictive value for difficult intubation.

Comparison of direct and video-assisted views of the larynx during routine intubation

“…However, in our study, the rate of unsuccessful intubation with the MVL using the monitor view (3 cases or 0.3%) is comparable with the rate of failed intubation in previous studies [20,[26][27][28][29][30][31][32]. The direct views in these 3 cases were graded 2a, 3, and 4, with only the grade 3 view improving to 2b with the video monitor.…”

A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy

“…[4527] Variations in the incidence of DVL have been attributed to different factors, such as different anthropomorphic features among populations, lack of uniformity in describing or grading laryngeal views, cricoid pressure application, head position, degree of muscle relaxation, and type or size of laryngoscope blade. [28]…”

“…[932] Many patients involuntarily phonate during assessment of the MMT score, whichmay considerably alter the Mallampati classification. [28]…”

Prediction of difficult tracheal intubation in Turkish patients: a multi-center methodological study

“…Anatolia lies at the junction of different cultures and the famous silk road that was actively used has contributed to a mixture of different ethnic races. Although there is a previous study about predicting difficult intubation in Turkish patients [5], our study is the first multi-centre study that includes patients from different geographic areas of Turkey.…”