Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
, 103 (2), 429-37

Predicting Difficult Intubation in Apparently Normal Patients: A Meta-Analysis of Bedside Screening Test Performance

Affiliations
Meta-Analysis

Predicting Difficult Intubation in Apparently Normal Patients: A Meta-Analysis of Bedside Screening Test Performance

Toshiya Shiga et al. Anesthesiology.

Abstract

The objective of this study was to systematically determine the diagnostic accuracy of bedside tests for predicting difficult intubation in patients with no airway pathology. Thirty-five studies (50,760 patients) were selected from electronic databases. The overall incidence of difficult intubation was 5.8% (95% confidence interval, 4.5-7.5%). Screening tests included the Mallampati oropharyngeal classification, thyromental distance, sternomental distance, mouth opening, and Wilson risk score. Each test yielded poor to moderate sensitivity (20-62%) and moderate to fair specificity (82-97%). The most useful bedside test for prediction was found to be a combination of the Mallampati classification and thyromental distance (positive likelihood ratio, 9.9; 95% confidence interval, 3.1-31.9). Currently available screening tests for difficult intubation have only poor to moderate discriminative power when used alone. Combinations of tests add some incremental diagnostic value in comparison to the value of each test alone. The clinical value of bedside screening tests for predicting difficult intubation remains limited.

Comment in

Similar articles

See all similar articles

Cited by 146 PubMed Central articles

See all "Cited by" articles

Publication types

LinkOut - more resources

Feedback