Diagnostic Accuracy of Mallampati Score in Patients under General Anesthesia Effect: A Cross Sectional Study.

Abstract

Introduction: Difficult airway management has been linked to significant morbidity
and death, and it is a fundamental and important problem for anesthesiologists.
Traditional clinical predictors are used to examine the airway prior to surgery.
Objectives: To compare the diagnostic accuracy of Mallampati score at both positions (supine and upright) with phonation to predict difficult laryngoscopy and intubation in patients after anesthesia administration.
Methodology: This cross-sectional study was conducted at Department of Anesthesia, Dow University of Health Sciences/Civil Hospital Karachi from July 2019 to January 2020. Patients on list for elective surgeries (like ENT surgery, general surgery,
ophthalmologic, neurosurgery, obstetric surgery, bypass surgery and orthopedic
surgery) under general anesthesia were selected. Mallampati score was estimated
with certain conditions like full extension of head, wide open mouth and extruded
tongue with phonation at two positions i.e., supine position and upright position.
Easy or difficult laryngoscopy and intubation was noted at both positions using Mallampati test.
Results: Enrolled patients are of age between 20-80 years and of both genders i.e.,
male and female. Sensitivity, specificity, negative predicted value, positive predicted
value, and overall diagnostic accuracy of the Mallampati score at upright position
was found to be 79%, 100%, 94%, 98% and 98% respectively. Sensitivity, specificity,
negative predicted value, positive predicted value, and overall diagnostic accuracy
of the Mallampati score at supine position was found to be 22%, 97%, 36%, 95%
and 92% respectively.
Conclusion: Patients with difficult laryngoscopy and intubation for general anesthesia have higher diagnostic accuracy of Mallampati score in upright position as compared to supine position with phonation.

Keywords: Mallampati score, supine versus upright position with phonation, laryngoscopy, intubation.