Are cardiac surgical patients at increased risk of difficult intubation?
Background and Aims: Safe airway management is the cornerstone of contemporary anaesthesia practice, and difficult intubation (DI) remains a major cause of anaesthetic morbidity and mortality. The surgical category, particularly cardiac surgery as a risk factor for DI has not been studied extensivel...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=8;spage=629;epage=635;aulast=Borde |
| _version_ | 1818286826209673216 |
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| author | Deepak Prakash Borde Savani Sameer Futane Vijay Daunde Sujata Zine Nayana Joshi Sumit Jaiswal Sadhana Chinchole Prasannakumar Kulkarni Amit Hiwarkar Priti Bhagyawant Dilip Deshmukh Manisha Takalkar |
| author_facet | Deepak Prakash Borde Savani Sameer Futane Vijay Daunde Sujata Zine Nayana Joshi Sumit Jaiswal Sadhana Chinchole Prasannakumar Kulkarni Amit Hiwarkar Priti Bhagyawant Dilip Deshmukh Manisha Takalkar |
| author_sort | Deepak Prakash Borde |
| collection | DOAJ |
| description | Background and Aims: Safe airway management is the cornerstone of contemporary anaesthesia practice, and difficult intubation (DI) remains a major cause of anaesthetic morbidity and mortality. The surgical category, particularly cardiac surgery as a risk factor for DI has not been studied extensively. The aim of this study was to test the hypothesis whether cardiac surgical patients are at increased risk of DI. Methods: During the study, 627 patients (329 cardiac and 298 non-cardiac surgical) were enrolled. Pre-operative demographic and other variables associated with DI were assessed. Patients with Cormack Lehane grade III and IV or use of bougie in Cormack grade II were defined as DI. The incidence of anticipated and unanticipated DI was assessed. Factors associated with DI were described using univariate and multivariate logistic regression models. Results: The overall incidence of DI was 122/627 (19.46%). The incidence of DI was higher in cardiac surgery patients (24%) as compared to non-cardiac surgery patients (14.4% P = 0.002). On multivariate analysis, factors independently associated with DI were greater age, male sex, higher Mallampati grade, and anticipated DI, but not cardiac surgery. The incidence of unanticipated DI was 48.1% and 53.4% in cardiac and non-cardiac surgery patients, respectively. Conclusion: Although there was a higher incidence of DI in cardiac surgical patients, cardiac surgery is not an independent risk factor for DI. Rather, other factors play more important role. About half of the DI both in cardiac and non-cardiac surgeries were unanticipated. |
| first_indexed | 2024-12-13T01:30:45Z |
| format | Article |
| id | doaj.art-a99cafaa4f13404fa3604bcb911beb9c |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-12-13T01:30:45Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-a99cafaa4f13404fa3604bcb911beb9c2022-12-22T00:04:01ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172017-01-0161862963510.4103/ija.IJA_283_17Are cardiac surgical patients at increased risk of difficult intubation?Deepak Prakash BordeSavani Sameer FutaneVijay DaundeSujata ZineNayana JoshiSumit JaiswalSadhana ChincholePrasannakumar KulkarniAmit HiwarkarPriti BhagyawantDilip DeshmukhManisha TakalkarBackground and Aims: Safe airway management is the cornerstone of contemporary anaesthesia practice, and difficult intubation (DI) remains a major cause of anaesthetic morbidity and mortality. The surgical category, particularly cardiac surgery as a risk factor for DI has not been studied extensively. The aim of this study was to test the hypothesis whether cardiac surgical patients are at increased risk of DI. Methods: During the study, 627 patients (329 cardiac and 298 non-cardiac surgical) were enrolled. Pre-operative demographic and other variables associated with DI were assessed. Patients with Cormack Lehane grade III and IV or use of bougie in Cormack grade II were defined as DI. The incidence of anticipated and unanticipated DI was assessed. Factors associated with DI were described using univariate and multivariate logistic regression models. Results: The overall incidence of DI was 122/627 (19.46%). The incidence of DI was higher in cardiac surgery patients (24%) as compared to non-cardiac surgery patients (14.4% P = 0.002). On multivariate analysis, factors independently associated with DI were greater age, male sex, higher Mallampati grade, and anticipated DI, but not cardiac surgery. The incidence of unanticipated DI was 48.1% and 53.4% in cardiac and non-cardiac surgery patients, respectively. Conclusion: Although there was a higher incidence of DI in cardiac surgical patients, cardiac surgery is not an independent risk factor for DI. Rather, other factors play more important role. About half of the DI both in cardiac and non-cardiac surgeries were unanticipated.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=8;spage=629;epage=635;aulast=BordeCardiac surgerydifficult intubationIndian patients |
| spellingShingle | Deepak Prakash Borde Savani Sameer Futane Vijay Daunde Sujata Zine Nayana Joshi Sumit Jaiswal Sadhana Chinchole Prasannakumar Kulkarni Amit Hiwarkar Priti Bhagyawant Dilip Deshmukh Manisha Takalkar Are cardiac surgical patients at increased risk of difficult intubation? Indian Journal of Anaesthesia Cardiac surgery difficult intubation Indian patients |
| title | Are cardiac surgical patients at increased risk of difficult intubation? |
| title_full | Are cardiac surgical patients at increased risk of difficult intubation? |
| title_fullStr | Are cardiac surgical patients at increased risk of difficult intubation? |
| title_full_unstemmed | Are cardiac surgical patients at increased risk of difficult intubation? |
| title_short | Are cardiac surgical patients at increased risk of difficult intubation? |
| title_sort | are cardiac surgical patients at increased risk of difficult intubation |
| topic | Cardiac surgery difficult intubation Indian patients |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=8;spage=629;epage=635;aulast=Borde |
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