Assessment of Difficult Intubation Predictors in Different Populations of Turkey

Abstract

Difficult tracheal intubation is defined when tracheal intubation requires multiple attempts, in the presence or absence of tracheal pathology. Most importantly, difficult intubation differs between countries and populations. Physicians should be aware of difficult intubation frequencies of their populations. Turkey is a transit country between East and West. Eastern Turkey reflects the Middle East and Asia, while western Turkey has European features. Our objectives were to investigate the frequency of difficult intubation in different regions’ populations, and specificity and sensitivity of predictive values. According to the population in the regions, 24 experienced anesthesiologists from 13 hospitals in 7 regions, were included in the study. Of 1313 patients, 143 patients (10.89%) were detected as difficult intubation. Mallampathy (MLP) III-IV were alone (p = 0.043), and the combination of thyromental distance <6 cm and MLP III-IV (p: 0.018) were statistically significant in difficult and easy intubation patient groups. The specificity was 97.46% in MLP + thyromental combination, and 98.05% in MLP + mouth opening combination. Western region had the shortest measurements in sternomental, thyromental and mouth opening (p <0.05), and had the most difficult intubation frequency compared to the other regions (p: 0.001). The positive predictive values were increased with increasing combinations, but further research is needed on the predictors of difficult intubation.