• Sandip Roy Basunia, Sarmila Ghosh, Susmita Bhattacharya, Indranil Saha, Atanu Biswas, and Anu Prasad.
• Department of Anaesthesiology, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
• Anesth Essays Res. 2013 Jan 1;7(1):105-9.

ContextThere is an impelling need for accurate tests to predict difficult intubation, as failure to achieve endotracheal intubation causes significant morbidity and mortality in anesthetic practice.AimTo calculate the validity of the different tests along with their combination and agreement when compared with endotracheal intubation in predicting difficult intubation.Settings And DesignOperation theaters, analytical study.Materials And MethodsThree hundred patients aged between 16 and 60 years of American society of anesthesiologist (ASA) physical status I and II, scheduled for elective surgical procedures requiring endotracheal intubation were studied during January-July 2012. Mallampati grade (MP), sternomental distance (SMD), thyromental distance (TMD), and Delilkan and Calder test were recorded for every patient. Endotracheal intubation was performed by an experienced anesthesiologist blinded to the measurements and recorded grading of intubation. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio (LR), odds ratio (OR), and kappa coefficient of tests individually and in combination were calculated.Statistical Analysis UsedIBM SPSS software (version 16.0) and Epi-info software (version 3.2).ResultsDifficult and failed intubation was 13.3% and 0.6%, respectively. Difficult intubation increased with age. TMD and Calder test showed highest sensitivity individually and Dellilkan's test showed least sensitivity. Among the combination of tests, MP with SMD and MP with Calder test had the highest sensitivity.ConclusionAmong individual test TMD and Calder are better predictive tests in terms of sensitivity. Combination of tests increases the chance of prediction of difficult intubation.

1 keywords...

hide…