title: The causes of difficult tracheal intubation and preoperative assessments in different age groups.
abstract: BACKGROUND
  We studied the differences in airway assessment factors among old, middle, and young age groups, and evaluated the frequency and causes of difficult intubation among these groups.
  
  
  METHODS
  Patients were divided into young (< 40 yr, n = 75 ), middle (40-59 yr, n = 83), and old (≥ 60 yr, n = 89) group. Airway assessment factors such as head and neck movement, thyromental distance, interincisor gap, dentition, Mallampati score, and Arné score were assessed. After muscle relaxation, cervical joint rigidity and Cormack-Lehane (C-L) grade were assessed. The differences in airway assessment factors between difficult (C-L grade 3, 4) and easy (C-L grade 1, 2) intubation were then examined. Logistic regression analysis was also carried out to identify the extent to which airway assessment factors reflected difficult intubation.
  
  
  RESULTS
  As aging, head and neck movement, thyromental distance, and interincisor gap decreased, the grade of dentition, Mallampati score, cervical joint rigidity and the ratio of Arné score > 11 increased. In the old and middle group, the incidence of difficult intubation was increased compared with the young group. Dentition in the young group, Mallampati score and interinsisor gap in the middle group and Mallampati score, cervical joint rigidity in the old group respectively predicted difficult intubation.
  
  
  CONCLUSIONS
  Compared to young individuals, middle-aged or elderly adults are likely to experience more difficulty in endotracheal intubation and its predictive factors could vary by age group.
authors: Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.
authors: Hyoung-Yong
authors: HY
authors: Moon
authors: Chong Wha
authors: CW
authors: Baek
authors: Jin-Seo
authors: JS
authors: Kim
authors: Gill Hoi
authors: GH
authors: Koo
authors: Jin-Yun
authors: JY
authors: Kim
authors: Young-Cheol
authors: YC
authors: Woo
authors: Yong Hun
authors: YH
authors: Jung
authors: Hyun
authors: H
authors: Kang
authors: Hwa-Yong
authors: HY
authors: Shin
authors: So-Young
authors: SY
authors: Yang
keywords: Aging; Difficult; Endotracheal intubation; Laryngoscopy
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