[Proposal for a new multifactor screening score of difficult intubation in ORL and stomatognathic surgery: preliminary study].
This study assessed prospectively in 295 ENT adult patients the predictive value of clinical indicators for difficult intubation and of a new multifactorial score, established by the allocation of points (0, 3, 5 or 7) depending on the degree of presence of seven factors: pathology known to be associated with a difficult intubation, clinical signs of airways' pathology, inter-incisors gap and mandible's luxation, submental mandibular-thyroid distance, normal or short and broad neck, head and neck movements, and Mallampati's test. The incidence of difficult laryngoscopy was 14% and the use of particular techniques for tube insertion was required in 8% of patients. The presence of malformation or pathology often associated with a difficult intubation and the presence of functional signs of airways' pathology predict the difficulties of laryngoscopy and tracheal intubation with a good sensitivity and specificity. The analysis of the "Receiver Operating Characteristic curves" showed that a score higher or equal to 11 allows the prediction of difficult intubations with a sensitivity of 96% and a specificity of 90%.
Descoins
P
P
Département d'Anesthésie-Réanimation Chirurgicale, CHU Poitiers.
Arné
J
J
Bresard
D
D
Ariès
J
J
Fusciardi
J
J
D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D010038:Otorhinolaryngologic Diseases / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D009057:Stomatognathic Diseases / Q000601:surgery*; D013515:Surgery, Oral / Q000295:instrumentation / Q000379:methods
Proposition d'un nouveau score multifactoriel de dépistage de l'intubation difficile en chirurgie ORL et stomatologique: étude préliminaire.