Upper incisor prominence is a good predictor of difficult intubation

Abstract

© 2018, Academy of Medical Sciences of Croatica. All rights reserved. Background and aim: One of the most important goals of pre-anesthesiologic evaluation is assessment of the airway. The aim of the present study was to determine the incidence of difficult intubation in surgical patients, and to establish which external anatomic factors are the best predictors of difficult intubation. Patients and methods: This prospective observational cross-sectional study included 200 adult patients who were scheduled to receive general anesthesia with intubation for elective surgical procedures. Results: Among 200 patients, 191 (95.5%) had normal intubation and 9 (4.5%) had difficult intubation. Age, height, body mass index, upper incisor prominence and interincisor gap were independently associated with difficult intubation. With every year of increase in age, the odds ratio for difficult intubation decreased by 7%. Odds of difficult intubation increased by 1.143 with each additional centimeter of patient height. Patients with prominent upper incisors were nearly seven times more likely to have difficult intubation. The odds of difficult intubation decreased by 96% in patients with the interincisor gap greater than 3 cm. Conclusion: Interincisor gap of less than 3 cm is a risk factor for difficult intubation, while those patients with prominent upper incisors are seven-fold more likely to have difficult intubation.