Analysis of El-Ganzouri Airway Risk Index and Modified LEMON Score (Leon Score) in Predicting Difficult Airway and Intubation in Elective Surgeries

Background: Accurate preoperative prediction of difficult airways is critical in anaesthetic practice to prevent adverse consequences.The El-Ganzouri Airway Risk Index and Modified LEMON Score are two prominent tools utilized for this purpose.However, the comparative predictive performance of these tools using univariate and multivariate analyses remains underexplored.To compare the predictive efficacy of EGRI and MLS for difficult airway and intubation using both univariate and multivariate analyses in patients experiencing elective surgeries under general anaesthesia.Methods: This prospective observational study was directed in a tertiary care hospital.An entire of 100 patients scheduled for elective surgeries under general anaesthesia with endotracheal intubation was measured preoperatively using EGRI and MLS.Univariate and multivariate logistic regression analyses were performed to evaluate the association of individual and composite variables with difficult laryngoscopy and intubation.The predictive power was measured using ROC curves and the area under the curve.Results: Both EGRI and MLS presented an important correlation with difficult laryngoscopy and intubation.In univariate analysis, apparatuses like inter-incisor gap and thyromental distance showed strong relations.Multivariate analysis exposed that the EGRI had a somewhat higher predictive power compared to MLS (AUC: 0.861 vs. 0.821). Conclusions:The study has concluded that ASA status III, Mallampati class III-IV, and inability to prognathy as significant independent predictors of difficult intubation.Among risk scores, a cut-off of EGRI 4 showed the best diagnostic performance with high sensitivity (81.6%) and specificity (85.5%), making it the most effective threshold for predicting difficult intubation in clinical settings.