EVALUATION OF AIRWAY INDICES FOR PREDICTING DIFFICULTY IN ENDOTRACHEAL INTUBATION IN PATIENTS WITH DIABETES MELLITUS

Abstract

Background:The need to predict potentially difcult tracheal intubation has received more importance but with limited success. The present study was conducted to assess various airway evaluation indices used to predict difcult airway in Indian patients with diabetes mellitus. Methods: This prospective, observational study was carried out in 85 patients at a tertiary care hospital in Western India. All patients underwent thorough airway assessment using modied Mallampati classication, mouth opening, upper lip bite test, thyromental distance, head extension, palm print, prayer sign and body mass index. Preoperative data of the various airway indices were co-related with difcult intubation to evaluate the sensitivity, specicity, positive predictive value and negative predictive value of each test. Results: Overall, the best indicator to predict difcult intubation in patients with diabetes was the palm print (58.7% sensitive; 94.9% specic; 75.3% accurate) followed by Mallampati score (50% sensitive; 94.9% specic; 70.6% accurate) and prayer sign (54.3% sensitive; 89.7% specic; 70.6% accurate). There was a signicant association between prediction of difcult intubation and occurrence of complications during intubation in patients with diabetes. Conclusion: Even though all airway indices have their place in an anesthesiologists' armamentarium, the palm print is an ideal predictor of difcult intubation in patients with diabetes, followed by the Mallampati score and the prayer sign.