A Comparison of Wilson Sum Score and Combination Mallampati, Tiromental and Sternomental Distances for Predicting Difficult Intubation

Aim. Our goal is to find the best predicting test for difficult intubation. Material and method. The present study is a double-blind, prospective one that has been made during the period of 2006-2008. It was perfomed in the Department of Surgery by the Service Of Anesthesiology and Intensive Care of the University Hospital Center “Mother Theresa” in Tirana, Albania. There were 426 ASA 1-2 adult patients involved in this study all of whom underwent general anesthesia for urologic and general surgery. All of the following parameters, i. e Mallampati score, tyromental sternomental and interincisive distances, Delilkan test , lower jaw protrusion and length , neck movement, body masss index, morfology of teeths, use of gidewire and Wilson score, were recorded for every patient. The dates were presented in absolute and relative mode, calculating also OD ratio and confidence interval of 95%. For each parameter were calculated the following: sensitivity, specificity, predictive positive value, and predictive negative value, with a significant P value < 0.05 (5%). Results. The total number of patients with difficult intubations was 40. Thirty seven patients had difficult intubations and 3 patients failed to be intubated. The specificity of all parameters was low, nevertheless the sensitivity was high. The combination of the parameters improved the predictive model, thus increasing the specificity. Wilson score predicted 33 patients with difficult intubations instead of 9 patients predicted by the combination of Mallampati-sternomental- tiromental distances. Conclusion. We concluded that the Wilson score was the best predictive test.