ArticlePatient safety in surgery2020
Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients: undergoing surgical procedures.
Article in Patient safety in surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Comparison of video laryngoscopy with direct laryngoscopy for intubation success in critically ill patients: a systematic review and Bayesian network meta-analysis.Frontiers in medicine · 2023Pooled it
- Prevalence and bedside predictors of difficult direct laryngoscopy among 3,080 adult elective surgical patients at a Cambodian tertiary center: a retrospective cohort study.BMC anesthesiology · 2026Article
- Variations of SPI during outpatient laparoscopic cholecystectomy without muscle relaxants using ANI-guided remifentanil.Journal of clinical monitoring and computing · 2025Observational
- Comparative efficacy of different doses of dexmedetomidine in sedation during awake fibreoptic nasotracheal intubation: A systematic review and meta-analysis.Indian journal of anaesthesia · 2025Article
- Comparison of modified Mallampati test with and without phonation for prediction of difficult laryngoscopy and intubation among adult surgical patients: cross-sectional study.Annals of medicine and surgery (2012) · 2025Article
- Factors predicting the use of the backward upward rightward pressure maneuver in thyroid surgery: a single-center retrospective cohort study.BMC surgery · 2024Article
- Macintosh-style videolaryngoscope use for tracheal intubation in elective surgical patients revisited: a sub-analysis of the 2022 Cochrane review data.Patient safety in surgery · 2024Article
- Evaluation of different doses of dexmedetomidine for awake fibreoptic nasotracheal intubation in patients undergoing oromaxillofacial and oral malignancy surgeries: A randomised, double-blind study.Indian journal of anaesthesia · 2024Article
- A Cross-Sectional Study of Anesthesia Safety in Wad Medani, Sudan: A Pre-war Status Indicating a Post-war Crisis.Cureus · 2024Article
- Comparison of two 3D scanning software to identify facial features: a prospective instrument to predict difficult airway.Perioperative medicine (London, England) · 2024Article
- Addition of flexible laryngoscopy to anesthesiological parameters improves prediction of difficult intubation in laryngeal surgery.Anaesthesiology intensive therapy · 2024Article
- Expert consensus on difficult airway assessment.Hepatobiliary surgery and nutrition · 2023Review
- An Evaluation of the Efficacy of Predictive Tests and Anthropometric Measurements in Determining Difficult Intubation in Children.Journal of clinical practice and research · 2023Article
- Assessment of predictors for difficult intubation and laryngoscopy in adult elective surgical patients at Tikur Anbessa Specialized Hospital, Ethiopia: A cross-sectional study.Annals of medicine and surgery (2012) · 2022Article
- The current state of anesthesia safety in a third world country: a cross-sectional survey among anesthesia providers in Ethiopia.Patient safety in surgery · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInadequate maintenance of a patient's airway represents a major cause of anesthesia-related morbidity and mortality. This study was designed to evaluate common preoperative clinical tests to determine the risk of difficult endotracheal intubation in apparent "normal" adult patients undergoing surgical procedures.
methodsA prospective observational cohort study was performed on 160 consecutive adult patients undergoing surgical procedures at an academic medical center in Jordan from 20 May 2019 until 11 February 2020. Preoperative assessment of airway risk stratification was performed by the following clinical tests: the mandible protrusion test (MPT), thyromental (TMD) and sternomental (SMD) distances, inter-incisor gap (IIG), and the modified Mallampati tests with tongue protrusion (MMT-TP) and without tongue protrusion (MMT-NTP). Grade C on the MPT, TMD ≤ 6 cm, SMD ≤ 12 cm, and MMT grades III and IV were considered to be predictors of difficult endotracheal intubations. A modified Cormack-Lehane grading (MCLG) of laryngoscopic views with backward, upward, and right-sided pressure on the thyroid and cricoid cartilages (BURP) maneuver was also documented, with grades 2B, 3, and 4 considered to be difficult airways for intubation.
resultsFifteen patients (9.4%) were classified as MCLG 2B, 3, and 4, with age significantly associated with the MCLG grade (P = 0.028). The sensitivity and Youden's index of MMT-TP were found to be the lowest (40% and 0.29, respectively). The MPT was the most accurate and specific test (90.63 and 95.17%, respectively), with the highest PPV (50%), Youden's index (0.42), and area under the curve (AUC) (0.781). Bivariant analysis of MPT and the t-test of the mean TMDs and SMDs revealed significant associations between these airway tests and the difficulty of intubation (P values: < 0.001, 0.02, < 0.01, respectively).
conclusionThe MPT, with its highest accuracy, specificity, positive predictive value, and good sensitivity may be used as a routine screening test for preoperative prediction of difficult endotracheal intubations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.