title: Lack of national consensus in preoperative airway assessment.
abstract: BACKGROUND
  Difficult airway management is associated with an increased risk of morbidity and mortality. Several preoperative risk factors associated with airway management difficulties have been proposed; however, no clear guideline for airway assessments exists. We therefore hypothesised that Danish airway assessment was lacking uniformity. We aimed to examine whether multivariable risk assessment tools and predictors for difficult intubation and mask ventilation were used systematically.
  
  
  METHODS
  Heads of anaesthesia departments were sent a six-question survey at the beginning of 2012. We asked if systematic risk assessment tools, particularly the Simplified Airway Risk Index (SARI), and predictors for difficult intubation and mask ventilation were used. Additionally, we asked if any risk factors were pre-printed on the anaesthesia record.
  
  
  RESULTS
  In all, 29 of 31 (94%) departments responded. The SARI was implemented in 8 of 29 (28%, 95% confidence interval (CI): 15-46%) departments with major regional differences. There was no significant association between using the SARI and a reduced number of unanticipated difficult intubation (p = 0.06). Mallampati classification (95.2%, 95% CI: 77.3-99.2%), history of airway management difficulties (85.7%, 95% CI: 65.4-95.0%), ability to prognath (81.0%, 95% CI: 60.0-92.3%) and neck mobility (81.0%, 95% CI: 60.0-92.3%) were the main predictors registered.
  
  
  CONCLUSIONS
  We found considerable inter-departmental variance in the standards employed for airway assessment and no uniform pattern in the registration of risk factors for airway management difficulties. Better prediction of difficult intubation could not be detected in departments that used the SARI.
  
  
  BACKGROUND
  none.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: anderskehlet@hotmail.com.
authors.forename: Anders K
authors.initials: AK
authors.lastname: Nørskov
authors.forename: Charlotte V
authors.initials: CV
authors.lastname: Rosenstock
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lundstrøm
mesh_terms: D058109:Airway Management / Q000379:methods / Q000592:standards*; D032921:Consensus; D019983:Guideline Adherence; D006801:Humans; D011300:Preoperative Care / Q000592:standards*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires