Prediction of difficult laryngoscopy in indian population

Role of ratio of patient's height to thyromental distance

H. M. Krishna, Munisha Agarwal, J. S. Dali, Prashant Rampal, C. K. Dua

Research output: Contribution to journalArticle

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Abstract

The ratio of the patient's height to thyromental distance (RHTMD) has been recently proposed to be a superior predictor of difficult laryngoscopy compared to thyromental distance (TMD) in the Caucasian population. This prospective study was conducted to compare the predictive value of RHTMD and TMD to predict difficult laryngoscopy in two hundred adult ASA grade I & II patients requiring general anaesthesia with endotracheal intubation. Preoperative airway assessment was done by TMD measurement and RHTMD calculation in addition to the routinely performed Wilson risk - sum scoring (WS) and modified Mallampati test (MMP). A standardized anaesthetic protocol was followed. Cormack and Lehane grade 3 or 4 laryngoscopic view was defined as difficult laryngoscopy. Data were analyzed using Receiver Operating Characteristic Curve (ROC) and the area under the curve (AUC) for each test was computed. P<0.05 was considered significant. The sensitivity, specificity, positive predictive value and negative predictive value were calculated at the cut-off value of =7 cm and =25 for TMD and RHTMD respectively. The incidence of difficult laryngoscopy was 8.5%. The AUC (confidence interval) were as follows: TMD - 0.295 (0.175 to 0.416) [P=0.005], RHTMD - 0.707 (0.574 to 0.840) [P=0.005], WS - 0.935 (0.856 to 1.014) [P=0.000], MMP - 0.805 (0.687 to 0.924) [P=0.000]. Thus we found that RHTMD has a better predictive value than the TMD in Indian population.

Original languageEnglish
Pages (from-to)257-260
Number of pages4
JournalJournal of Anaesthesiology Clinical Pharmacology
Volume21
Issue number3
Publication statusPublished - 07-2005

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Laryngoscopy
Population
Area Under Curve
Intratracheal Intubation
ROC Curve
General Anesthesia
Anesthetics
Prospective Studies
Confidence Intervals
Sensitivity and Specificity
Incidence

All Science Journal Classification (ASJC) codes

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Anesthesiology and Pain Medicine
  • Pharmacology (medical)

Cite this

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title = "Prediction of difficult laryngoscopy in indian population: Role of ratio of patient's height to thyromental distance",
abstract = "The ratio of the patient's height to thyromental distance (RHTMD) has been recently proposed to be a superior predictor of difficult laryngoscopy compared to thyromental distance (TMD) in the Caucasian population. This prospective study was conducted to compare the predictive value of RHTMD and TMD to predict difficult laryngoscopy in two hundred adult ASA grade I & II patients requiring general anaesthesia with endotracheal intubation. Preoperative airway assessment was done by TMD measurement and RHTMD calculation in addition to the routinely performed Wilson risk - sum scoring (WS) and modified Mallampati test (MMP). A standardized anaesthetic protocol was followed. Cormack and Lehane grade 3 or 4 laryngoscopic view was defined as difficult laryngoscopy. Data were analyzed using Receiver Operating Characteristic Curve (ROC) and the area under the curve (AUC) for each test was computed. P<0.05 was considered significant. The sensitivity, specificity, positive predictive value and negative predictive value were calculated at the cut-off value of =7 cm and =25 for TMD and RHTMD respectively. The incidence of difficult laryngoscopy was 8.5{\%}. The AUC (confidence interval) were as follows: TMD - 0.295 (0.175 to 0.416) [P=0.005], RHTMD - 0.707 (0.574 to 0.840) [P=0.005], WS - 0.935 (0.856 to 1.014) [P=0.000], MMP - 0.805 (0.687 to 0.924) [P=0.000]. Thus we found that RHTMD has a better predictive value than the TMD in Indian population.",
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Prediction of difficult laryngoscopy in indian population : Role of ratio of patient's height to thyromental distance. / Krishna, H. M.; Agarwal, Munisha; Dali, J. S.; Rampal, Prashant; Dua, C. K.

In: Journal of Anaesthesiology Clinical Pharmacology, Vol. 21, No. 3, 07.2005, p. 257-260.

Research output: Contribution to journalArticle

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T1 - Prediction of difficult laryngoscopy in indian population

T2 - Role of ratio of patient's height to thyromental distance

AU - Krishna, H. M.

AU - Agarwal, Munisha

AU - Dali, J. S.

AU - Rampal, Prashant

AU - Dua, C. K.

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AB - The ratio of the patient's height to thyromental distance (RHTMD) has been recently proposed to be a superior predictor of difficult laryngoscopy compared to thyromental distance (TMD) in the Caucasian population. This prospective study was conducted to compare the predictive value of RHTMD and TMD to predict difficult laryngoscopy in two hundred adult ASA grade I & II patients requiring general anaesthesia with endotracheal intubation. Preoperative airway assessment was done by TMD measurement and RHTMD calculation in addition to the routinely performed Wilson risk - sum scoring (WS) and modified Mallampati test (MMP). A standardized anaesthetic protocol was followed. Cormack and Lehane grade 3 or 4 laryngoscopic view was defined as difficult laryngoscopy. Data were analyzed using Receiver Operating Characteristic Curve (ROC) and the area under the curve (AUC) for each test was computed. P<0.05 was considered significant. The sensitivity, specificity, positive predictive value and negative predictive value were calculated at the cut-off value of =7 cm and =25 for TMD and RHTMD respectively. The incidence of difficult laryngoscopy was 8.5%. The AUC (confidence interval) were as follows: TMD - 0.295 (0.175 to 0.416) [P=0.005], RHTMD - 0.707 (0.574 to 0.840) [P=0.005], WS - 0.935 (0.856 to 1.014) [P=0.000], MMP - 0.805 (0.687 to 0.924) [P=0.000]. Thus we found that RHTMD has a better predictive value than the TMD in Indian population.

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