A documented previous difficult tracheal intubation as a prognostic test for a subsequent difficult tracheal intubation in adults

TY - JOUR

T1 - A documented previous difficult tracheal intubation as a prognostic test for a subsequent difficult tracheal intubation in adults

AU - Lundstrøm, L H

AU - Møller, A M

AU - Rosenstock, C

AU - Astrup, G

AU - Gätke, M R

AU - Wetterslev, J

N1 - Keywords: Adult; Aged; Aged, 80 and over; Epidemiologic Methods; Female; Humans; Intubation, Intratracheal; Laryngoscopy; Male; Middle Aged; Prognosis; Treatment Failure

PY - 2009

Y1 - 2009

N2 - SUMMARY: We investigated the diagnostic accuracy of a documented previous difficult tracheal intubation as a stand-alone test for predicting a subsequent difficult intubation. Our assessment included patients from the Danish Anaesthesia Database who were scheduled for tracheal intubation by direct laryngoscopy. We used a four-point scale to grade the tracheal intubation. A previous difficult intubation was defined according to the presence of a record documenting a difficult penultimate tracheal intubation-score for the 15 499 patients anaesthetised more than once. Our assessment demonstrates that a documented history of previous difficult or failed intubation using direct laryngoscopy are strong predictors of a subsequent difficult or failed intubation and may identify 30% of these patients. Although previous investigators have reported predictive values that exceed our findings markedly, a documented previous difficult or failed tracheal intubation appears in everyday anaesthetic practice to be a strong predictor of a subsequent difficult tracheal intubation.

AB - SUMMARY: We investigated the diagnostic accuracy of a documented previous difficult tracheal intubation as a stand-alone test for predicting a subsequent difficult intubation. Our assessment included patients from the Danish Anaesthesia Database who were scheduled for tracheal intubation by direct laryngoscopy. We used a four-point scale to grade the tracheal intubation. A previous difficult intubation was defined according to the presence of a record documenting a difficult penultimate tracheal intubation-score for the 15 499 patients anaesthetised more than once. Our assessment demonstrates that a documented history of previous difficult or failed intubation using direct laryngoscopy are strong predictors of a subsequent difficult or failed intubation and may identify 30% of these patients. Although previous investigators have reported predictive values that exceed our findings markedly, a documented previous difficult or failed tracheal intubation appears in everyday anaesthetic practice to be a strong predictor of a subsequent difficult tracheal intubation.

U2 - 10.1111/j.1365-2044.2009.06057.x

DO - 10.1111/j.1365-2044.2009.06057.x

M3 - Journal article

C2 - 19735399

SN - 0003-2409

VL - 64

SP - 1081

EP - 1088

JO - Anaesthesia

JF - Anaesthesia

IS - 10

ER -