Pre-assessment of airways for good prediction of difficult intubation on elective operation

The methods As part of our work, we selected to put out focus on the pre-operational assessment which is routinely done by anesthesiologist. We will examine the potency and the strength of the pre-op assessment which serves as the major tool to predict difficult intubation. ASSUTA group is the largest private health care centers in Israel and include 4 healthcare centers, 4 private hospitals and 1 public hospital. Within the ASSSUTA group, 13% of all surgical procedures in Israel are performed and about 85,000 elective surgeries each year. The large volume of surgical procedures have done within the group combined with the advance informatics systems in use, created a large database that will serve as the base for our work. The database contains more than 120K elective operations of ASSUTA health care group in 2016-2021. Every patient expecting a surgery will answer a standard questionnaire and out of them, just the patient that didn’t pass it will go through full pre-op assessment by anesthesiologist. The questionnaire supposed to select the more complex patient with potential for difficult airway. All the anamnestic information, clinical data and the physical examination were collected from the patient during the pre-op assessment would be kept and be sorted in out database. In addition to these data of the patient record from the pre-op assessment, data from the operation itself would be added and includes: type of the anesthesia, meds were used during the op and data from the execution anesthesia process. As part of our work we will try to answer: 1) Is it possible to get good prediction about difficulty with intubation of elective operation by pre-op assessment exams? 2) What are the best parameters that are related for the prediction of difficult intubation? 1. The method a. A request will be drafted and submitted to Helsinki's committee in order to give a green light to begin the work and to grant patient's information access. b. After obtaining the permission from the committee, we will extract the data from the hospital's database c. We will process and filter the data and select the patients which the anesthesiologist labeled as were "difficult intubation" d. Data analyzing 2. Results: The pre-operational assessment is sub -optimal tool in order to predict difficult intubation with sensitivity of 22% and specificity of 94%. Mallampati score serve as the strongest parameter to predict difficult intubation out of the parameters checked. 3. Conclusion: Although the pre-operational assessment is a good tool that succeed to predict difficult intubation, pre-op assessment is far from perfect and suffer from relative weak predictive value to predict difficult intubation and the research efforts should be kept in order to develop more accurate tool to predict difficult intubation

The method As part of our work, we selected to put out focus on the pre-operational assessment which is routinely done by anesthesiologist. We will examine the potency and the strength of the pre-op assessment which serves as the major tool to predict difficult intubation. ASSUTA group is the largest private health care centers in Israel and include 4 healthcare centers, 4 private hospitals and 1 public hospital. Within the ASSSUTA group, 13% of all surgical procedures in Israel are performed and about 85,000 elective surgeries each year. The large volume of surgical procedures have done within the group combined with the advance informatics systems in use, created a large database that will serve as the base for our work. The database contains more than 120K elective operations of ASSUTA health care group in 2016-2021. Every patient expecting a surgery will answer a standard questionnaire and out of them, just the patient that didn’t pass it will go through full pre-op assessment by anesthesiologist. The questionnaire supposed to select the more complex patient with potential for difficult airway. All the anamnestic information, clinical data and the physical examination were collected from the patient during the pre-op assessment would be kept and be sorted in out database. In addition to these data of the patient record from the pre-op assessment, data from the operation itself would be added and includes: type of the anesthesia, meds were used during the op and data from the execution anesthesia process. As part of our work we will try to answer: 1) Is it possible to get good prediction about difficulty with intubation of elective operation by pre-op assessment exams? 2) What are the best parameters that are related for the prediction of difficult intubation? 1. The method a. A request will be drafted and submitted to Helsinki's committee in order to give a green light to begin the work and to grant patient's information access. b. After obtaining the permission from the committee, we will extract the data from the hospital's database c. We will process and filter the data and select the patients which the anesthesiologist labeled as were "difficult intubation" d. Data analyzing 2. Results: The pre-operational assessment is sub -optimal tool in order to predict difficult intubation with sensitivity of 22% and specificity of 94%. Mallampati score serve as the strongest parameter to predict difficult intubation out of the parameters checked. 3. Conclusion: Although the pre-operational assessment is a good tool that succeed to predict difficult intubation, pre-op assessment is far from perfect and suffer from relative weak predictive value to predict difficult intubation and the research efforts should be kept in order to develop more accurate tool to predict difficult intubation