Analysis of a national difficult airway database

Area of Science:

• Anesthesiology
• Patient Safety
• Health Informatics

Background:

• Difficult airway management poses significant risks to patient care and outcomes.
• Predicting future airway difficulties remains a clinical challenge.
• Previous difficult airway experiences are the strongest indicator of future events.

Purpose of the Study:

• To analyze the first 5 years of data from a national difficult airway database.
• To report on patient characteristics, airway management strategies, and outcomes.
• To identify factors associated with critical airway incidents.

Main Methods:

• Analysis of data from 675 adult patients in the national difficult airway database.
• Review of clinical airway assessments, history of difficult airways, and anticipated difficulty.
• Examination of airway-related critical incidents, including re-awakening, ICU admission, and major adverse events.

Main Results:

• Clinical airway assessment was documented in 94% of patients.
• A history of difficult airway was known in 20% of patients.
• 11% of patients experienced an airway-related critical incident, with events like emergency front-of-neck airway or cardiac arrest occurring in 1 in 225 patients.

Conclusions:

• Unanticipated difficult airway management persists despite current assessment protocols.
• The rate of critical incidents in this patient cohort is notably high.
• The national difficult airway database offers potential for future improvements in patient airway management.