Comparison of Difficult Intubation and Neck Circumference to Thyromental Distance Ratio, in Obese and Non-Obese: A Clinical Study
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 3
Abstract
Background: This study was conducted to assess whether intubation is more difficult in obese patients compared to non-obese and to assess the ability of ratio of the neck circumference to thyromental distance (NC/TM), to predict difficult intubation in obese patients. Methods: This study is a cross sectional study. After obtaining institutional approval, consenting patients were enrolled in this study. The incidence of difficult tracheal intubation in 166 obese (BMI≥25 kg/ m2) and 166 non-obese patients was compared. Difficult intubation was determined using the Intubation Difficulty Scale (IDS≥5).Airway assessment indices were evaluated for their relation to IDS. NC/TM was calculated and its ability to predict difficult intubation in obese patients as well as non obese patients was assessed. Results: Difficult intubation was more frequent in obese patients than in non-obese patients (14.5% vs 7.2 %;P =0.031). NC/TM at a cut-off ≥ 4.99 showed the high sensitivity, specificity and a positive likelihood ratio, and large area under the curve on ROC curve in the obese. Conclusion: Difficult intubation defined by IDS were common in obese patients compared to non-obese. Neck circumference to thyromental distance ratio ≥ 4.99 yielded a very high sensitivity, specificity and positive likelihood ratio in the obese group. Therefore, it may be used as a screening test for predicting difficult intubation in the obese.
Authors and Affiliations
Nadia Rose
Keywords
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