title: BMI as a Predictor for Potential Difficult Tracheal Intubation in Males.
abstract: BACKGROUND
  Difficult tracheal intubation is a common source of mortality and morbidity in surgical and critical care settings. The incidence reported of difficult tracheal intubation is 0.1%-13% and reaches 14% in the obese population. The objective of our retrospective study was to investigate and compare the utility of body mass index (BMI) as indicator of difficult tracheal intubation in males and females.
  
  
  METHODS
  We performed a retrospective chart review of patients who underwent abdominal surgeries with American Society of Anesthesiologists I to V under general anesthesia requiring endotracheal intubation. The following information was obtained from medical records for analysis: gender, age, height, weight, BMI, length of patient stay in the Post Anesthesia Care Unit, past medical history of sleep apnea, Mallampati score, and the American Society of Anesthesiologists classification assigned by the anesthesia care provider performing the endotracheal intubation.
  
  
  RESULTS
  Of 4303 adult patients, 1970 (45.8%) men and 2333 (54.2%) women were enrolled in the study. Within this group, a total of 1673 (38.9%) patients were morbidly obese. The average age of the study group was 51.4 ± 15.8 and the average BMI was 29.7 ± 8.2 kg/m(2). The overall incidence of the encountered difficult intubations was 5.23% or 225 subjects. Thus, our results indicate that BMI is a reliable predictor of difficult tracheal intubation predominantly in the male population; another strong predictor, with a positive linear correlation, being the Mallampati score.
  
  
  CONCLUSIONS
  In conclusion, our data shows that BMI is a reliable indicator of potential difficult tracheal intubation only in male surgical patients.
authors.affiliation: Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Uribe
authors.affiliation: The University of North Carolina , Chapel Hill, NC , USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Zvara
authors.affiliation: Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
authors.forename: Erika G
authors.initials: EG
authors.lastname: Puente
authors.affiliation: Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Otey
authors.affiliation: Center for Biostatistics, The Ohio State University , Columbus, OH , USA.
authors.forename: Jianying
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA ; Neurological Surgery, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
authors.forename: Sergio D
authors.initials: SD
authors.lastname: Bergese
keywords: BMI; difficult; obesity; predictors; tracheal intubation