Comparison Of Modified Mallampati Classification With Cormack And Lehane Grading In Predicting Difficult Laryngoscopy Among elective surgical Patients Who Took General Anesthesia in W/C/S/H- cross Sectional study
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Date
2021-04
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Addis Abeba University
Abstract
Background: Difficult laryngoscopy/intubation cause various complications likes
hypoxia, brain damage or even death if it is not managed early. Appropriate airway
assessment in the preoperative period is an important task and in patients with no
apparent difficult airway indicator, Modified Mallampati test (MMT) alone is used
frequently to predict difficult airway even if its predictive value is low. Cormack and
Lehane grading (CLG) is the gold standard but not applied before anesthesia.
Objective: It was to compare modified mallampati classification (MMC) with
Cormack and Lehane grading in predicting difficult laryngoscopy among patients who
took general anesthesia.
Method: Institutional based cross sectional survey study was conducted among 141
elective surgical patients with no apparent difficult airway indicator from February
2021 to April 2021. The correlation between MMC and CLG was calculated using
spearman’s correlation coefficient, and the area under curve (AUC) was analyzed
using receiver operating characteristics (ROC) curve analysis for MMT.
Result: The incidence of difficult laryngoscopy and intubation were 14.9% and 9.2%
respectively. Spearman correlation coefficient ( ) was 0.330 with p 0.001. AUC
against difficult laryngoscopy and intubation was 0.705 & 0.726 respectively.
Sensitivity and specificity of MMT were 47.6% & 93.3% for difficult laryngoscopy
and 53.8% and 91.4% for difficult intubation respectively.
Conclusion and Recommendation: Correlation between MMC and CLG was low.
Sensitivity of MMT was also low. Therefore, additional clinical tests are necessary as
part of screening test for difficult airway.
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Keywords
Difficult laryngoscopy, modified mallampati classification, cormak and lehane grading