Accuracy of thyromental height test for predicting difficult intubation in elderly

Area of Science:

• Anesthesiology
• Geriatric Medicine
• Airway Management

Background:

• Limited studies exist on the accuracy of airway tests in the elderly population.
• Assessing the predictive accuracy of thyromental height against traditional airway tests in elderly patients is crucial.

Purpose of the Study:

• To evaluate and compare the accuracy of thyromental height in predicting difficult tracheal intubation in elderly patients.
• To compare thyromental height with other traditional airway tests (modified Mallampati, thyromental distance, sternomental distance) for predicting difficult intubation.

Main Methods:

• 120 patients aged 65 years or older undergoing general anesthesia with tracheal intubation were included.
• Thyromental height, modified Mallampati test, thyromental distance, and sternomental distance were assessed.
• Difficult laryngoscopy (Cormack-Lehane grade > 2) and difficult tracheal intubation ( > 2 attempts) were recorded. Predictive accuracy was determined using Area Under the Receiver Operating Characteristic (AUROC) curves.

Main Results:

• Difficult laryngoscopy occurred in 12% and difficult intubation in 17% of patients.
• Thyromental height (AUROC: 0.90) and modified Mallampati test (AUROC: 0.89) demonstrated the highest accuracy in predicting difficult intubation.
• Low thyromental height and high modified Mallampati test scores were identified as independent risk factors for difficult laryngoscopy and intubation.

Conclusions:

• Thyromental height and modified Mallampati test are accurate predictors of difficult intubation and laryngoscopy in elderly patients undergoing elective procedures.
• Thyromental distance and sternomental distance were found to be poor predictors of difficult airway management in this population.