Efficacy of Airway Assessment Variables as Predictors of Difficult Intubation among Northeastern Population in India: A Hospital Based Prospective Study
Tridip J. Borah1, Md Yunus2, Habib Md R Karim3, Laltanpuii Sailo4, Samarjit Dey5
1Senior Resident 2Addl. Professor, 4,5Assistant Professor, Department of Anaesthesiology and Critical Care, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya 793012, India. 3Assistant Professor, Department of Anaesthesiology and Critical Care, Andaman and Nicobar Islands Institute of Health and Medical Sciences, Port Blair, Andaman and Nicobar Islands 744104, India.
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Background and aim: Difficult intubation is an important cause of mortality in surgical patients; even more so when it is unanticipated. Predicting difficult intubation with the help of different airway parameters has been the endeavor of all anesthesiologists. However, there are variations in the accuracy of these airway parameters due to differences in race and ethnicity. The present study was aimed to assess the efficacy of various airway parameters in predicting difficult intubation in the northeast Indian population. Methods: Four hundred adult American Society of Anesthesiologists physical status I and II patients scheduled for elective surgery under general anaesthesia requiring tracheal intubation were assessed preoperatively for different predicting factors of difficult laryngoscopy and intubation. Intubation difficulty was assessed by the Intubation Difficulty Scale. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. The association between different variables and difficult intubation was evaluated using Fishers exact test; p-value < 0.05 was considered significant. Results: The mean age of the patients was 43.40±12.49 years; 60% patients were male. 23 (5.75%) patients were having difficult intubation. While all the parameters were strongly able to predict difficulty, thyromental distance < 6 cm and Cormack Lehane grade 3 were having the most strong relative risk (8 and 100.22 respectively; p < 0.0001 for both). Only Cormack Lehane grade 3 was having both good sensitivity and specificity (95.65% and 86.74% respectively). Conclusion: Difficult intubation rate is not different in northeastern Indian population. Thyromental distance , Modified Mallampati score and Cormack Lehane view were the strongest predictors of difficult intubation in the study population.
Corresponding Author : Md Yunus, Sub dean (Research) and Addl. Prof., Department of Anaesthesiology and Critical Care, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya 793012, India.
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