Korean J Anesthesiol.  2013 Apr;64(4):308-314. 10.4097/kjae.2013.64.4.308.

The causes of difficult tracheal intubation and preoperative assessments in different age groups

• Moon HY
• Baek CW
• Kim JS
• Koo GH
• Kim JY
• Woo YC
• Jung YH
• Kang H
• Shin HY
• Yang SY

• KMID: 2299367
• DOI: http://doi.org/10.4097/kjae.2013.64.4.308

Abstract

BACKGROUND
We studied the differences in airway assessment factors among old, middle, and young age groups, and evaluated the frequency and causes of difficult intubation among these groups.
METHODS
Patients were divided into young (< 40 yr, n = 75 ), middle (40-59 yr, n = 83), and old (> or = 60 yr, n = 89) group. Airway assessment factors such as head and neck movement, thyromental distance, interincisor gap, dentition, Mallampati score, and Arne score were assessed. After muscle relaxation, cervical joint rigidity and Cormack-Lehane (C-L) grade were assessed. The differences in airway assessment factors between difficult (C-L grade 3, 4) and easy (C-L grade 1, 2) intubation were then examined. Logistic regression analysis was also carried out to identify the extent to which airway assessment factors reflected difficult intubation.
RESULTS
As aging, head and neck movement, thyromental distance, and interincisor gap decreased, the grade of dentition, Mallampati score, cervical joint rigidity and the ratio of Arne score > 11 increased. In the old and middle group, the incidence of difficult intubation was increased compared with the young group. Dentition in the young group, Mallampati score and interinsisor gap in the middle group and Mallampati score, cervical joint rigidity in the old group respectively predicted difficult intubation.
CONCLUSIONS
Compared to young individuals, middle-aged or elderly adults are likely to experience more difficulty in endotracheal intubation and its predictive factors could vary by age group.

Keyword

Aging; Difficult; Endotracheal intubation; Laryngoscopy

MeSH Terms

Adult
Aged
Aging
Dentition
Head
Humans
Incidence
Intubation
Intubation, Intratracheal
Joints
Laryngoscopy
Logistic Models
Muscle Relaxation
Neck