作者
Agarwal R, Jain G, Agarwal A, Govil N
发表日期
2021
期刊
Korean Journal of Anesthesiology
卷号
74
期号
2
页码范围
134-141
出版商
Korean Society of Anaesthesiologists
简介
Background
Predicting difficult intubation (DI) is a key challenge, as no single clinical predictor is sufficiently valid to predict the outcome. We evaluated the effectiveness of four upper airway ultrasonographic parameters in predicting DI. The validity of the models using combinations of ultrasonography-based parameters was also investigated.
Methods
This prospective, observational, double-blinded cohort trial enrolled 1,043 surgical patients classified as American Society of Anesthesiologists physical status I–III without anticipated difficult airway. Preoperatively, their tongue thickness (TT), invisibility of hyoid bone (VH), and anterior neck soft tissue thickness from the skin to thyrohyoid membrane (ST) and hyoid bone (SH) were measured by sublingual and submandibular ultrasonography. The logistic regression, Youden index, and receiver operator characteristic analysis results were reported.
Results
Overall, 58 (5.6%) patients were classified as DI. The TT, SH, ST, and VH had accuracies of 78.4%, 85.0%, 84.7%, and 84.9%, respectively. The optimal values of TT, SH, and ST for predicting DI were> 5.8 cm (sensitivity: 84.5%, specificity: 78.1%, AUC: 0.880),> 1.4 cm (sensitivity: 81%, specificity: 85.2%, AUC: 0.898) and> 2.4 cm (sensitivity: 75.9%, specificity: 85.2%, AUC: 0.885) respectively. VH had a sensitivity and specificity of 72.4% and 85.6%(AUC: 0.790). The AUC values of the five models (with combinations of three or four parameters) ranged from 0.975–0.992. ST and VH had a significant impact on the individual models.
Conclusions
SH had the best accuracy. Individual parameters showed limited validity. The model including all four …
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R Agarwal, G Jain, A Agarwal, N Govil - Korean journal of anesthesiology, 2021