An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx
Background and Aims: Bedside screening test for predicting difficult intubation is an accepted practice, even though its clinical value remains limited. This study aimed to study the predicting value of acromioaxillosuprasternal notch index (AASI) for difficult visualisation of the larynx (DVL). Met...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2018;volume=62;issue=12;spage=945;epage=950;aulast=Rajkhowa |
| _version_ | 1818151801890799616 |
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| author | Tejwant Rajkhowa Priyam Saikia Deepjyoti Das |
| author_facet | Tejwant Rajkhowa Priyam Saikia Deepjyoti Das |
| author_sort | Tejwant Rajkhowa |
| collection | DOAJ |
| description | Background and Aims: Bedside screening test for predicting difficult intubation is an accepted practice, even though its clinical value remains limited. This study aimed to study the predicting value of acromioaxillosuprasternal notch index (AASI) for difficult visualisation of the larynx (DVL). Methods: After Hospital Ethical Committee approval, 440 consecutive consenting adult non-obstetric patients were included in this study. AASI, modified Mallampati class (MMT), sternomental distance (SMD), thyromental distance (TMD) and inter incisor distance (IID) were evaluated preoperatively by trained personnel. Visualisation of larynx was graded according to Cormack–Lehane grading, with grade III and IV being considered as DVL. The cut-off values for prediction of DVL were defined a priori. Direct laryngoscopy was carried out by qualified anaesthesiologists blinded to the results of the airway predictors under evaluation. Primary outcome variable was AASI as a predictor of DVL. Comparing DVL with MMT, SMD, TMD and IID were secondary objectives. Results: DVL was observed in 3.6% [95% confidence interval (1.9–5.4%)] patients. We observed that sensitivity, specificity and Area Under Curve i.e., AUC (95% confidence interval) of ROC of AASI was 81.25 (53.69-95.03), 96.7 (94.39-98.11) and 0.890 (0.777-1.000) respectively. AUC of AASI was found to better than MMT, SMD, TMD and IID. Conclusion: AASI (≥0.5) is a good predictor of difficult visualisation of the larynx at direct laryngoscopy. |
| first_indexed | 2024-12-11T13:44:36Z |
| format | Article |
| id | doaj.art-d82bbfaa304c4d3bb5e459f635fddaca |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-12-11T13:44:36Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-d82bbfaa304c4d3bb5e459f635fddaca2022-12-22T01:04:35ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172018-01-01621294595010.4103/ija.IJA_480_18An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynxTejwant RajkhowaPriyam SaikiaDeepjyoti DasBackground and Aims: Bedside screening test for predicting difficult intubation is an accepted practice, even though its clinical value remains limited. This study aimed to study the predicting value of acromioaxillosuprasternal notch index (AASI) for difficult visualisation of the larynx (DVL). Methods: After Hospital Ethical Committee approval, 440 consecutive consenting adult non-obstetric patients were included in this study. AASI, modified Mallampati class (MMT), sternomental distance (SMD), thyromental distance (TMD) and inter incisor distance (IID) were evaluated preoperatively by trained personnel. Visualisation of larynx was graded according to Cormack–Lehane grading, with grade III and IV being considered as DVL. The cut-off values for prediction of DVL were defined a priori. Direct laryngoscopy was carried out by qualified anaesthesiologists blinded to the results of the airway predictors under evaluation. Primary outcome variable was AASI as a predictor of DVL. Comparing DVL with MMT, SMD, TMD and IID were secondary objectives. Results: DVL was observed in 3.6% [95% confidence interval (1.9–5.4%)] patients. We observed that sensitivity, specificity and Area Under Curve i.e., AUC (95% confidence interval) of ROC of AASI was 81.25 (53.69-95.03), 96.7 (94.39-98.11) and 0.890 (0.777-1.000) respectively. AUC of AASI was found to better than MMT, SMD, TMD and IID. Conclusion: AASI (≥0.5) is a good predictor of difficult visualisation of the larynx at direct laryngoscopy.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2018;volume=62;issue=12;spage=945;epage=950;aulast=RajkhowaAcromioaxillosuprasternal notch indexintratracheal/methodsintubationlaryngoscopy/methodspredictive value of testssensitivity and specificity |
| spellingShingle | Tejwant Rajkhowa Priyam Saikia Deepjyoti Das An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx Indian Journal of Anaesthesia Acromioaxillosuprasternal notch index intratracheal/methods intubation laryngoscopy/methods predictive value of tests sensitivity and specificity |
| title | An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx |
| title_full | An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx |
| title_fullStr | An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx |
| title_full_unstemmed | An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx |
| title_short | An observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx |
| title_sort | observational prospective study of performance of acromioaxillosuprasternal notch index in predicting difficult visualisation of the larynx |
| topic | Acromioaxillosuprasternal notch index intratracheal/methods intubation laryngoscopy/methods predictive value of tests sensitivity and specificity |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2018;volume=62;issue=12;spage=945;epage=950;aulast=Rajkhowa |
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