Difficult Laryngoscopy Prediction Score for Intubation in Emergency Departments: A Retrospective Cohort Study
Issued Date
2022-01-01
Resource Type
eISSN
11791500
Scopus ID
2-s2.0-85133728952
Journal Title
Open Access Emergency Medicine
Volume
14
Start Page
311
End Page
322
Rights Holder(s)
SCOPUS
Bibliographic Citation
Open Access Emergency Medicine Vol.14 (2022) , 311-322
Suggested Citation
Savatmongkorngul S., Pitakwong P., Sricharoen P., Yuksen C., Jenpanitpong C., Watcharakitpaisan S. Difficult Laryngoscopy Prediction Score for Intubation in Emergency Departments: A Retrospective Cohort Study. Open Access Emergency Medicine Vol.14 (2022) , 311-322. 322. doi:10.2147/OAEM.S372768 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86339
Title
Difficult Laryngoscopy Prediction Score for Intubation in Emergency Departments: A Retrospective Cohort Study
Author's Affiliation
Other Contributor(s)
Abstract
Objective: Difficult laryngoscopy is associated with difficult intubation, an increasing number of endotracheal intubation attempts, and adverse events. Clinical prediction of difficult airways in an emergency setting was limited in sensitivity and specificity. This study developed a new model for predicting difficult laryngoscopy in the emergency department. Methods: This retrospective cohort study was conducted using an exploratory model at the Emergency Medicine of Ramathibodi Hospital. The study was conducted from June 2018 to July 2020. The eligibility criteria were an age of ≥15 years who undergo intubation in the emergency department. Difficult laryngoscopy was defined as a Cormack–Lehane grade 3 and above. The predictive model and score were developed by multivariable logistic regression analysis. Results: A total of 617 patients met the eligibility criteria; 83 (13.45%) had difficult laryngoscopy. Five independent factors were predictive of difficult laryngoscopy. Significant factors were M: limited mouth opening, O: presence of obstructed airway, N: poor neck mobility, T: large tongue, and H: short hypo-mental distance. The difficult laryngoscopy score had an accuracy of 89%. A score of >4 increased the likelihood ratio of difficult laryngoscopy by 7.62 times. Conclusion: The MONTH Difficult Laryngoscopy Score of >4 was associated with difficult laryngoscopy.