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A documented previous difficult tracheal intubation as a prognostic test for a subsequent difficult tracheal intubation in adults
Author(s) -
Lundstrøm L. H.,
Møller A. M.,
Rosenstock C.,
Astrup G.,
Gätke M. R.,
Wetterslev J
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2009.06057.x
Subject(s) - intubation , medicine , tracheal intubation , laryngoscopy , anesthesia , surgery
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.