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Background: A thorough but brief airway assessment is important and challenging for patients requiring advanced airway assessment. The study aimed to provide knowledge about the factors leading to difficult endotracheal intubation, reduce the number of attempts which will lead to more successful intubation and improve the overall quality of the procedure. Material Methods: A total of 293 patients were selected based on consecutive sampling methods. After ethical committee clearance data was collected using a data collection form. Age, gender, obesity,pre-existing medical conditions, and facial malformations were recorded for each participant. Airway assessment tests such as mouth opening, thyromental distance, hyomental distance, short neck, and Mallampati classes were conducted by investigators. Inclusion criteria were based on 1. The patient who is alive 2. The patient who needs advanced airway management The exclusion criteria were 1. The patient presented in the emergency department with ventilator support 2. Patient who didnt give consent 3. Patients below 14 years of age(pediatric age group) Data was initially entered into an Excel data sheet and then exported to SPSS Statistics version 22 for analysis. Results:From July 2022 to Aug 2023, a total of 293 patients were included in the study. Of these, 170 were male and 123 were female. Under 65 years of age 40 (43.5%) had difficult intubation whereas above 65 years 52(56.5%) had difficult intubation. 134 patients were obese resulting in difficult intubation. Female patients, those suffering from systemic diseases and facial malformation or fracture were found to be more difficult to intubate. We recognized that Mallampati classes ≥3, mouth opening < 4cm, short thyromental distance, and hyomental distance, were also associated with difficult intubation. Multiple logistic regression analysis of the related factors determined that the odds ratio was highest for mouth opening <4 cm (OR = 3.613) and Thyromental distance <6cm (OR = 3.157) Conclusion: Factors affecting difficult intubation were constructed from the patients demographic characteristics and clinical examination. This may help in discriminating against difficult intubation.This will also help in the overall success rate of first attempts of endotracheal intubation in the emergency department.
Agrawal et al. (Sun,) studied this question.