Seo et al reported a score for identifying a patient who may face a difficult intubation. This is based on 7 factors associated with difficult intubation. The authors are from Kosin University in Busan, Korea.
Patient selection: adult undergoing intubation for surgery
Parameters:
(1) Mallampati classification (Class I to IV)
(2) thyromental distance in cm (distance from thyroid notch to chin with neck fully extended)
(3) head and neck movement in degrees
(4) body mass index (BMI) in kilograms per square meter
(5) buck teeth status (severe if upper teeth protrude more than 0.5 cm beyond lower)
(6) inter-incisor gap in cm with mouth opened as wide as possible
(7) upper lip bite test (ULBT, Class I to III)
|
Parameter |
Finding |
Points |
|
Mallampati class |
Class I |
0 |
|
|
Class II |
1 |
|
|
Class III or IV |
2 |
|
thyromental distance |
> 6.5 cm |
0 |
|
|
6 to 6.5 cm |
1 |
|
|
< 6 cm |
2 |
|
head and neck movement |
> 90 degrees |
0 |
|
|
90 degrees |
1 |
|
|
< 90 degrees |
2 |
|
BMI |
< 25 kg per sq m |
0 |
|
|
>= 25 kg per sq m |
1 |
|
buck teeth |
none |
0 |
|
|
mild |
1 |
|
|
severe |
2 |
|
inter-incisor gap |
> 5 cm |
0 |
|
|
4 to 5 cm |
1 |
|
|
< 4 cm |
2 |
|
upper lip bite test |
Class I |
0 |
|
|
Class II |
1 |
|
|
Class III |
2 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 13
• A score > 6 was associated with a difficult intubation.
• The odds ratio for difficult intubation with a score > 6 was 13.6.
Specialty: Anesthesiology, Surgery, general, Pulmonology, Cardiology, Emergency Medicine, Otolaryngology
