Comparison of modified mallampati classification with Cormack and Lehane grading in predicting difficult laryngoscopy among elective surgical patients who took general anesthesia in Werabie comprehensive specialized hospital - Cross sectional study. Ethiopia, 2021

Abstract

BackgroundDifficult laryngoscopy/intubation can cause a multitude of issues, including hypoxia, brain damage, and even death if not addressed swiftly. The Modified Mallampati test (MMT) is frequently used to predict difficult airway in patients with no clear difficult airway signal, despite its limited predictive power, in patients with no obvious difficult airway signal. Cormack and Lehane grading (CLG) is the gold standard, however it is not utilized before anesthesia. ObjectiveTo compare modified Mallampati classification (MMC) with Cormack and Lehane grading in predicting difficult laryngoscopy among patients who took general anesthesia. MethodAn institutionally based cross sectional survey study of 141 elective surgical patients with no obvious difficult airway sign was conducted from February to April 2021. The correlation between MMC and CLG was computed using spearman's correlation coefficient, and the area under the curve (AUC) for MMT was assessed using receiver operating characteristics (ROC) curve analysis. ResultThe incidence of difficult laryngoscopy and intubation, respectively, was 14.9% and 9.2%. The Spearman correlation coefficient (ρ) was 0.330, with a significance level of 0.001. The AUCs for difficult laryngoscopy and intubation, respectively, were 0.705 and 0.726. MMT had 47.6% sensitivity and 93.3% specificity for difficult laryngoscopy and 53.8% and 91.4% specificity for difficult intubation, respectively. Conclusionand Recommendation: There was little correlation between MMC and CLG. MMT sensitivity was similarly low. As a result, as part of the screening test for difficult airway, extra clinical tests are required.