Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study
Abstract Background Maintaining patent airways is vital in pediatric anesthetic management. Failure to manage and anticipate difficult laryngoscopy (DL) preoperatively is the leading cause of morbidity and mortality. Data on the predictive values of screening parameters in predicting DL are limited...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-022-01901-4 |
| _version_ | 1811207662388379648 |
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| author | Mulualem Sitot Wubayehu Amare Adugna Aregawi |
| author_facet | Mulualem Sitot Wubayehu Amare Adugna Aregawi |
| author_sort | Mulualem Sitot |
| collection | DOAJ |
| description | Abstract Background Maintaining patent airways is vital in pediatric anesthetic management. Failure to manage and anticipate difficult laryngoscopy (DL) preoperatively is the leading cause of morbidity and mortality. Data on the predictive values of screening parameters in predicting DL are limited in children. Therefore, this study aimed to assess the predictive value of the modified Mallampati test (MMT), upper lip bite test (ULBT), thyromental distance (TMD), and ratio of height to thyromental distance (RHTMD) in predicting DL in children aged 5–12 years at selected Addis Ababa governmental hospitals in Ethiopia. Methods A multicenter cross-sectional study was conducted on 141 elective pediatric surgical patients aged 5 to 12 years selected using a systematic random sampling technique at three governmental hospitals from December 1, 2021, to April 30, 2022. The collected data were entered and analysed by SPSS version 26. Chi-square and Fisher’s exact tests were used to compare categorical variables. The receiver operating characteristic curve analysis was used to compare the accuracy of MMT, ULBT, TMD, and RHTMD against DL. A P value < 0.05 was considered statistically significant. Results The magnitude of DL was 15.6%. MMT has the highest sensitivity (86.4%), specificity (91.6%), and negative predictive value (NPV) (97.3%) compared to other tests. The ULBT also has a high sensitivity (72.7%) and specificity (84%) with comparable diagnostic accuracy (90.8%) with the MMT (P < 0.05). The sensitivity, specificity, positive predictive value (PPV), NPV, and accuracy of TMD were 63.6%, 95.8%, 73.7%, 93.4%, and 82.2%, respectively. The RHTMD has the lowest specificity (63.6%), PPV (22.5%), NPV (91.4%), and accuracy (56.7%) in predicting DL. Conclusion The MMT and ULBT are good screening tests, followed by the TMD in predicting DL, while the RHTMD was the least accurate predictor. Because no single test has 100% predictive value, a combination of screening tests is advised in pediatrics for predicting DL. |
| first_indexed | 2024-04-12T04:08:40Z |
| format | Article |
| id | doaj.art-6d0565a11bf34ea8bf39eca8fcf6b8c9 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-12T04:08:40Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-6d0565a11bf34ea8bf39eca8fcf6b8c92022-12-22T03:48:34ZengBMCBMC Anesthesiology1471-22532022-11-012211910.1186/s12871-022-01901-4Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional studyMulualem Sitot0Wubayehu Amare1Adugna Aregawi2Department of Anesthesia, College of Health Sciences, School of Medicine, Addis Ababa UniversityDepartment of Anesthesia, College of Health Sciences, School of Medicine, Addis Ababa UniversityDepartment of Anesthesia, College of Health Sciences, School of Medicine, Addis Ababa UniversityAbstract Background Maintaining patent airways is vital in pediatric anesthetic management. Failure to manage and anticipate difficult laryngoscopy (DL) preoperatively is the leading cause of morbidity and mortality. Data on the predictive values of screening parameters in predicting DL are limited in children. Therefore, this study aimed to assess the predictive value of the modified Mallampati test (MMT), upper lip bite test (ULBT), thyromental distance (TMD), and ratio of height to thyromental distance (RHTMD) in predicting DL in children aged 5–12 years at selected Addis Ababa governmental hospitals in Ethiopia. Methods A multicenter cross-sectional study was conducted on 141 elective pediatric surgical patients aged 5 to 12 years selected using a systematic random sampling technique at three governmental hospitals from December 1, 2021, to April 30, 2022. The collected data were entered and analysed by SPSS version 26. Chi-square and Fisher’s exact tests were used to compare categorical variables. The receiver operating characteristic curve analysis was used to compare the accuracy of MMT, ULBT, TMD, and RHTMD against DL. A P value < 0.05 was considered statistically significant. Results The magnitude of DL was 15.6%. MMT has the highest sensitivity (86.4%), specificity (91.6%), and negative predictive value (NPV) (97.3%) compared to other tests. The ULBT also has a high sensitivity (72.7%) and specificity (84%) with comparable diagnostic accuracy (90.8%) with the MMT (P < 0.05). The sensitivity, specificity, positive predictive value (PPV), NPV, and accuracy of TMD were 63.6%, 95.8%, 73.7%, 93.4%, and 82.2%, respectively. The RHTMD has the lowest specificity (63.6%), PPV (22.5%), NPV (91.4%), and accuracy (56.7%) in predicting DL. Conclusion The MMT and ULBT are good screening tests, followed by the TMD in predicting DL, while the RHTMD was the least accurate predictor. Because no single test has 100% predictive value, a combination of screening tests is advised in pediatrics for predicting DL.https://doi.org/10.1186/s12871-022-01901-4Predictive valueModified Mallampati testThyromental distanceRatio of Height to TMDUpper lip bite testDifficult laryngoscopy |
| spellingShingle | Mulualem Sitot Wubayehu Amare Adugna Aregawi Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study BMC Anesthesiology Predictive value Modified Mallampati test Thyromental distance Ratio of Height to TMD Upper lip bite test Difficult laryngoscopy |
| title | Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study |
| title_full | Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study |
| title_fullStr | Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study |
| title_full_unstemmed | Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study |
| title_short | Predictive values of the modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5–12 years old at selected Addis Ababa governmental hospitals, Ethiopia: a multicenter cross-sectional study |
| title_sort | predictive values of the modified mallampati test upper lip bite test thyromental distance and ratio of height to thyromental distance to predict difficult laryngoscopy in pediatric elective surgical patients 5 12 years old at selected addis ababa governmental hospitals ethiopia a multicenter cross sectional study |
| topic | Predictive value Modified Mallampati test Thyromental distance Ratio of Height to TMD Upper lip bite test Difficult laryngoscopy |
| url | https://doi.org/10.1186/s12871-022-01901-4 |
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