PREDICTION OF INCIDENCE OF DIFFICULT INTUBATION BY MODIFIED MALLAMPATI TEST (MMT) AND INTUBATION DIFFICULTY SCALE (IDS) SCORE IN PATIENTS UNDERGOING GENERAL ANAESTHESIA

BACKGROUND: Difficult airway management is major cause of morbidity and mortality in anaesthesia practice. The prevalence of difficult intubation - 0.1% to 10.1%. The aim of current study was to predict incidence of difficult intubation using Modified Mallampati test and Intubation Difficulty Scale. MATERIALS & METHODS: After Institutional ethical committee approval, a hospital based observational study was done by recruiting 70 subjects with the American society of anaesthesiologists Class 1, 2 undergoing elective surgeries under general anaesthesia by endotracheal intubation. Modified Mallampati Test (MMT) was assessed preoperatively. Intubation difficulty scale (IDS) score was recorded during intubation. The primary outcome includes the prediction of difficult intubation as described by IDS score, patients were classified into two groups with IDS score of ≥5 and <5 as the difficult and easy intubation groups, respectively. Data analysed using Receiver operating characteristic (ROC) curve and Area under Curve (AUC). RESULTS: The mean age of subjects was 36.81±13.08 years. The percentage of difficult intubation was 5.7% by IDS and 28.6% by MMT. 94.2% had IDS score<5. Age and Body mass index correlates with increased IDS score predicting difficult intubation (p≤0.05; r = 0.499, r = 0.51) respectively. The AUC for IDS score was 0.727 (p = 0.003) which was statistically significant. The sensitivity of the IDS score was 15% and specificity was 98%. CONCLUSION: The MMT being the gold standard and IDS scoring system a validated method based on subjective and objective criteria, used to evaluate a global degree of intubation difficulty to decrease the incidence of airway related complications by using simple maneuvers and techniques.