A Comparative Study of Predicting Difficult Intubation by Six Indexes of Thyromental Height (TMH), Acromioaxillary-Suprasternal Notch Index (AASI), Modified Mallampati Test (MMT), Upper Lip Biting Test (ULBT), Height to Thyromental Distance Ratio (RHTMD),

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical sciences, Isfahan, Iran

2 Resident, Department of Anesthesiology, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran

Abstract

Background: This study aimed to compare the ability of predicting difficult intubation by six indexes of thyromental height (TMH), acromioaxillary-suprasternal notch index (AASI), modified mallampati test (MMT), upper lip biting test (ULBT), height to thyromental distance ratio (RHTMD), and neck circumference to thyromental height ratio (NC/TMH) in patients undergoing general anesthesia.Methods: In this cross-sectional study, 600 patients undergoing surgeries were selected, and difficult laryngoscopy was evaluated using above the six tests. The cut-of-point and diagnostic values were determined in comparison with Cormack-Lehane index.Findings: The NC/TMH test had the highest sensitivity (80.6%) and AASI had the highest specificity (94.8%). Moreover, among the six testes, NC/TMH had the highest positive predictive value (PPV), and ULBT had highest negative predictive value (NPV). ULBT had the highest positive likelihood ratio and TMH had the highest negative likelihood ratio.Conclusion: Compared with the other tests, NC/TMH, AASI, and TMH had better diagnostic values for evaluating airway, and can be used to detect difficult laryngoscopy.

Keywords

References

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Journal of Isfahan Medical School
Volume 37, Issue 517 - Serial Number 517
January and February 2019
Pages 169-175

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History

  • Receive Date: 07 December 2018
  • Revise Date: 26 May 2024
  • Accept Date: 06 April 2022

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