Is Mallampati classification a good screening test? A prospective cohort evaluating the predictive values of Mallampati test at different thresholds
Braz. J. Anesth. (Impr.)
;
72(6): 736-741, Nov.-Dec. 2022. tab, graf
Article
Dans Anglais
| LILACS
| ID: biblio-1420622
ABSTRACT
Abstract Background There is currently some discussion over the actual usefulness of performing preoperative upper airway assessment to predict difficult airways. In this field, modified Mallampati test (MMT) is a widespread tool used for prediction of difficult airways showing only a feeble predictive performance as a diagnostic test. We therefore aimed at evaluating if MMT test would perform better when used as a screening test rather than diagnostic. Methods An accuracy prospective study was conducted with 570 patients undergoing general anesthesia for surgical procedures. We collected preoperatively data on sex, age, weight, height, body mass index (BMI), ASA physical status, and MMT. The main outcome was difficult laryngoscopy defined as Cormack and Lahane classes 3 or 4. Bivariate analyses were performed to build three different predictive models with their ROC curves. Results Difficult laryngoscopy was reported in 36 patients (6.32%). Sex, ASA physical status, and MMT were associated with difficult laryngoscopy, while body mass index (BMI) was not. The MMT cut-off with the highest odds ratio was the class II, which also presented significantly higher sensitivity (94.44%). The balanced accuracy was 67.11% (95% CI 62.78-71.44%) for the cut-off of class II and 71.68% (95% CI 63.83-79.54) for the class III. Conclusion MMT seems to be more clinically useful when the class II is employed as the threshold for possible difficult laryngoscopies. At this cut-off, MMT shows the considerable highest sensitivity plus the highest odds ratio, prioritizing thus the anticipation of difficult laryngoscopies.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Intubation trachéale
/
Larynx
Type d'étude:
Etude diagnostique
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
/
Étude de dépistage
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Braz. J. Anesth. (Impr.)
Année:
2022
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Hospital das Clínicas de Pernambuco/BR
/
Instituto de Medicina Integral Professor Fernando Figueira/BR
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