AI Summary & Key Takeaways
AI InsightMallampati III-IV and SMD were found to be the most sensitive measurements however none of the tests or test combinations had clinical significance.
📌 3 Key Takeaways
Abstract
Aim: In our study we aimed to identify the most sensitive and highest positive predictive test or test combinations in order to find the most reliable method in our daily practice.Materials and Methods: After approval from the ethics committee, we included 561 patients (older than 18 years old, ASA I-III). Demographic properties, Mallampati scoring (MP), thyromental distance (TMD), sternomental distance (SMD) and mouth opening (MO) were recorded. Following premedication, anaesthesia was induced and muscle relaxants were given and laryngoscopy was performed. Cormack-Lehane I-II was accepted as easy laryngoscopy while III-IV was accepted as difficult. Student t test, chi-square and Mc Nemar chi-square tests were used for statistical analysis and p< 0.05 was considered significant.Results: Incidence of difficult intubation was found to increase with age, weight, BMI and male sexuality (p< 0.05). Difficult intubation was found to be 18.5 % while difficult laryngoscopy was 13 %.Conclusions: Sensitivity increased and specifisity decreased when we used the cut off points of our study. Mallampati III-IV and SMD were found to be the most sensitive measurements however none of the tests or test combinations had clinical significance.
Özet
Amaç: Zor entübasyonu belirlemede en yüksek duyarlılık ve pozitif öngörü değerine sahip test veya test kombinasyonlarının belirlenmesi ve böylece pratikte kullanabileceğimiz en güvenilir metodun saptanması amaçlandı.Gereç ve Yöntem: Etik komite izni alınarak, 18 yaş üzeri 561 hasta çalışmaya dahil edildi. Demografik özellikler, Mallampati skoru (MP), tiromental mesafe (TMM), sternomental mesafe (SMM) ve ağız açıklığı (AA) kaydedildi. Premedikasyon, anestezi indüksiyonu ve kas gevşetici verilmesini takiben laringoskopiye geçildi. Cormack-Lehane I-II; kolay, III-IV zor laringoskopi olarak kabul edildi. İstatistiksel analizde student t test, ki-kare ve Mc Nemar ki-kare testleri kullanıldı ve p< 0.05 anlamlı kabul edildi.Bulgular: Zor entübasyonun yaş, kilo, BMI ve erkek cinsiyet ile arttığı tespit edildi (p< 0.05). Zor entübasyon insidensi % 18.5, zor laringoskopi ise, % 13 olarak bulundu.Sonuç: Elde ettiğimiz eşik değerleri kullandığımızda duyarlılık artarken, seçiciliğin azaldığı görüldü. MP III-IV ve SMM en yüksek duyarlılığa sahip testler olmasına rağmen, testlerin veya test kombinasyonlarının hiçbirinin klinik anlamlılığı tespit edilmedi.