Accuracy of Wilson risk score in predicting difficult tracheal intubation / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of Wilson risk score in predicting difficult tracheal intubation. Methods American Society of Anesthesiologists physical statusⅠ-Ⅲ patients of both sexes, aged≥18 yr, undergoing elective surgery with general anesthesia, were enrolled in the study. All the pa-tients were evaluated by the special researchers for assessment of the preoperative airway. The assessment i-tems included the Wilson risk score ( 5 risk factors weight, jaw movement, head and neck movement, mandible receding, buck teeth), modified Mallampati classification, thyromental distance, inter-incisor distance, etc. After the airway assessment was completed, anesthesia induction was conducted, and tra-cheal intubation was performed after 3 min of pressure ventilation under the mask. The primary outcome was difficult tracheal intubation. The receiver operating characteristic curve and area under the curve ( AUC) were used to analyze the efficacy of the corresponding parameters in diagnosing difficult tracheal intubation. The optimal predictive cut-off value and corresponding sensitivity and specificity of the parameters were de-termined by using the Youden index. Results A total of 1544 patients were enrolled in this study, and difficult intubation was found in 37 cases. The analysis of receiver operating characteristic curve showed that the AUC of the modified Mallampati classification was 0. 65, and the AUC of the thyromental distance was 0. 81, and the AUC of the Wilson risk score was 0. 91. Compared with the modified Mallampati classifica-tion and thyromental distance, the AUC of Wilson risk score was significantly increased when used for pre-dicting difficult tracheal intubation (P<0. 05). Compared with the inter-incisor distance, no significant change was found in the AUC of Wilson risk score in predicting difficult tracheal intubation ( P>0. 05) . The optimal predictive cut-off value of the Wilson risk score was more than 1, which was determined by the Youden index. Conclusion Wilson risk score provides better efficacy than the modified Mallampati classi-fication and thyromental distance in predicting difficult tracheal intubation.