A retrospective review of difficult intubations: is obstructive sleep apnea a predictor?

The purpose of this study was to examine the association of obstructive sleep apnea (OSA) with difficult intubation in patients undergoing general anesthesia requiring tracheal intubation.

Using a retrospective, case-control study design, 90 adults with difficult tracheal intubation were compared with 81 gender-matched controls, between 2007 and 2010. Analyses included descriptive and inferential statistics, and multivariate regression was used to estimate predictors of difficult intubation while adjusting for patient demographics.

In the univariate analysis, OSA was not associated with difficult intubation. After patient factors were controlled for in the multivariate logistic regression, patients without OSA were more likely to have difficult intubation (odds ratio, 0.36; 95% confidence interval, 0.13-0.99; P = .048). Other predictors of difficult intubation were lower body mass index and higher Mallampati score.

In adult subjects, OSA history was not a predictor of difficult intubation. Other patient or anesthesiologist factors should be assessed for their association with difficult intubation.