Thyromental height test as a predictor of difficult airway. Single test versus multivariate predictive models. A cohort study
Ollaek, M., Abo Elela, S., Ahmed, A., Abdel Rahman, N., ElKholy, G., Gorgy, A., Reda, I., Mohamed, D. (2022). Thyromental height test as a predictor of difficult airway. Single test versus multivariate predictive models. A cohort study. EKB Journal Management System, 38(1), 622-628. doi: TEJA-2022-0179
Mohamed Ollaek; Shady Abo Elela; Abeer Ahmed; Neamat Abdel Rahman; Gehan ElKholy; Antony Gorgy; Islam Reda; Dina Mohamed. "Thyromental height test as a predictor of difficult airway. Single test versus multivariate predictive models. A cohort study". EKB Journal Management System, 38, 1, 2022, 622-628. doi: TEJA-2022-0179
Ollaek, M., Abo Elela, S., Ahmed, A., Abdel Rahman, N., ElKholy, G., Gorgy, A., Reda, I., Mohamed, D. (2022). 'Thyromental height test as a predictor of difficult airway. Single test versus multivariate predictive models. A cohort study', EKB Journal Management System, 38(1), pp. 622-628. doi: TEJA-2022-0179
Ollaek, M., Abo Elela, S., Ahmed, A., Abdel Rahman, N., ElKholy, G., Gorgy, A., Reda, I., Mohamed, D. Thyromental height test as a predictor of difficult airway. Single test versus multivariate predictive models. A cohort study. EKB Journal Management System, 2022; 38(1): 622-628. doi: TEJA-2022-0179

Thyromental height test as a predictor of difficult airway. Single test versus multivariate predictive models. A cohort study

Egyptian Journal of Anaesthesia
Volume 38, Issue 1, December 2022, Page 622-628  XML PDF (1.11 MB)
DOI: TEJA-2022-0179
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Authors
Mohamed Ollaek; Shady Abo Elela; Abeer Ahmed; Neamat Abdel Rahman; Gehan ElKholy; Antony Gorgy; Islam Reda; Dina Mohamed
Abstract
Background
Thyromental height test (TMHT) revealed good potential to predict difficult airway but with variable cut-off values. This study aimed to assess the validity of TMHT either as a sole test or within multivariable models for predicting difficult airway.
Methods
The study included 612 patients aged ≥18 years who were scheduled for elective surgeries under general anaesthesia with an endotracheal tube. Airway was assessed with TMHT, Thyromental distance (TMD), Sternomental distance (SMD), inter-incisor distance (IID), and Modified Mallampati test (MMT). The difficult laryngoscopy (DL) was defined as Cormack–Lehane (C-L) grade > 2. The primary outcome was the validity of TMHT as a predictor for DL.
Results
Cases with DL were 56 (9.2%) patients, while cases with difficult intubation (DI) were 7 (1.1%). The TMHT was significantly shorter in cases with DL compared to easy laryngoscopy (45.82 ± 8.21 versus 56.93 ± 8.83 mm, respectively) and in cases with DI compared to easy intubation (42 ± 7.19 versus 56.07 ± 9.24 mm respectively). TMHT was a good predictor for both DL and DI at a cut-off value of ≤ 48 mm with an AUROC (Area Under the Receiver Operating Characteristic) curve of 0.82 (95% CI: 0.79 to 0.85) and 0.89 (95% CI: 0.82 to 0.92), respectively. The logistic regression analysis incorporated the TMHT within two multivariable predictive models for DL and DI with better predictive ability.
Conclusion
In adult surgical patients, TMHT is a good objective predictor for DL and DI. The predictive ability increased when incorporated into two multivariable models.
Trial registration
ClinicalTrials.gov, ID: NCT04264338 in February 2020.
Keywords
Thyromental height test; Thyromental distance; sternomental distance; modified mallampati; airway predictive models; Difficult intubation; Difficult laryngoscopy
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