The Simplified Predictive Intubation Difficulty Score: a new weighted score for difficult airway assessment

L'Hermite, J; Nouvellon, Emmanuel; Cuvillon, Philippe; Fabbro‐Peray, Pascale; Langeron, Olivier; Ripart, Jacques

doi:10.1097/eja.0b013e32832efc71

Cited by 55 publications

(39 citation statements)

References 30 publications

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“…The anesthesia literature has demonstrated factors associated with difficult intubation (eg, obesity and short thyromental distance) [14][15][16][17]. By contrast, in the ED setting, the evidence to predict difficult airways remains scarce.…”

Section: Introductionmentioning

confidence: 98%

Prospective validation of the modified LEMON criteria to predict difficult intubation in the ED

Hagiwara

Watase

Okamoto

et al. 2015

The American Journal of Emergency Medicine

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Section: Introductionmentioning

confidence: 98%

Prospective validation of the modified LEMON criteria to predict difficult intubation in the ED

Hagiwara

Watase

Okamoto

et al. 2015

The American Journal of Emergency Medicine

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“…This is consistent with other studies. [82526] In the obese group of our study, age >40 years and SMD <12.5 cm were the only significant predictors of difficult intubation. Although obese are slightly more difficult to intubate than lean patients, the actual weight or BMI grading of obese people did not predict who will have IDS >5.…”

Section: Discussionmentioning

confidence: 60%

“…However, the relationship between grading of laryngoscopy and difficult intubation is being questioned. [25] Kim, et al . [21] and Juvin, et al .…”

Section: Discussionmentioning

confidence: 99%

Comparing ease of intubation in obese and lean patients using intubation difficulty scale

et al. 2014

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Background:Difficult tracheal intubation contributes to significant morbidity and mortality during induction of anesthesia. There are divided opinions regarding ease of intubation in obese patients. Moreover, the definition of difficult intubation is not uniform; hence we have use the Intubation Difficulty Scale (IDS) to find the incidence of difficult intubation in obese patients.Aims:The primary aim of the following study is to find out the incidence of difficult intubation in obese and lean patients using IDS and secondary aim is to assess the performance of bedside screening tests to predict difficult intubation, mask ventilation and laryngoscopy in obese and lean patients.Materials and Methods:A prospective, observational cohort study of 200 patients requiring general anesthesia were categorized into 100 each based on body mass index (BMI) into lean (BMI <25 kg/m2) and obese (BMI ≥25 kg/m2) groups. IDS score ≥5 was termed as difficult intubation. Pre-operative airway assessment included Mallampati score, mouth opening, neck circumference (NC), upper lip bite test, thyromental distance, sternomental distance (SMD) and head neck mobility. Patients having difficulty in mask ventilation and laryngoscopy was recorded.Results:Over all in 200 patients the incidence of difficult intubation was 9%. Obese patients were slightly more difficult to intubate than lean (11% vs. 7%, P = 0.049). Age >40 years, NC >35 cm, SMD <12.5 cm and restricted head neck mobility were factors which were associated with IDS ≥5. Multivariate analysis revealed SMD <12.5 cm to predict difficult intubation in obese patients. Obese patients were difficult to mask ventilate (6% vs. 1%, P = 0.043). There was no difference regarding grading of laryngoscopy between the two groups.Conclusion:Obese patients are difficult to mask ventilate and intubate. During intubation of obese patients who is more than 40 years age and SMD <12.5 cm, it is preferable to have a second skilled anesthesiologist.

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“…The score is equal to the total number of risk factors present for an individual patient. (4) The predictive properties should be better than chance, and the discrimination power [area under a receiver operating characteristic (ROC) curve] should be increased by at least 20% (from 0.50 to 0.70) in an independent set of patients. (5) There should be a correlation between the number of risk factors present and the likelihood of difficult intubation.…”

Section: Methodsmentioning

confidence: 99%

“…Unfortunately, more recent approaches are even more complicated. 4 This suggests the need for a simpler and easier composite tool. Thus, the aim of this study was to set up a practicable new predictive model and to validate it using a separate set of patients.…”

Section: Introductionmentioning

confidence: 98%

A simplified risk score to predict difficult intubation: development and prospective evaluation in 3763 patients

Eberhart

Arndt

Aust

et al. 2010

European Journal of Anaesthesiology

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The new simplified multivariate risk score for difficult intubation may prove to be useful in clinical practice for predicting a difficult airway. Presence of upper front teeth, a history of difficult intubation, any Mallampati status different from '1' and equal to '4' and mouth opening less than 4 cm are independent risk factors for difficult endotracheal intubation. With each of these risk factors, the likelihood increases from 0 (when no risk factor is present) to 17% (when four or five factors are present).

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The Simplified Predictive Intubation Difficulty Score: a new weighted score for difficult airway assessment

Cited by 55 publications

References 30 publications

Prospective validation of the modified LEMON criteria to predict difficult intubation in the ED

Prospective validation of the modified LEMON criteria to predict difficult intubation in the ED

Comparing ease of intubation in obese and lean patients using intubation difficulty scale

A simplified risk score to predict difficult intubation: development and prospective evaluation in 3763 patients

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