Radiological indicators and a novel combined predictive model for anticipating difficult laryngoscopy in cervical spondylosis patients: a prospective cohort study.

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY
Jiao Li, Yang Tian, Mingya Wang, Jingchao Fang, Hua Zhang, Feng Yue, Mao Xu, Jun Wang, Min Li, Xiangyang Guo, Yongzheng Han
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引用次数: 0

Abstract

Backgrounds: Anticipating difficult laryngoscopy is crucial for preoperative assessment, especially for patients with cervical spondylosis. Radiological assessment has become essential for improving airway management safety. This research introduces novel radiological indicators from lateral cervical X-ray in the extended head position proposed to enhance the accuracy of predicting difficult laryngoscopy.

Methods: A prospective cohort study included 422 patients scheduled for elective cervical spine surgery. The Cormack-Lehane grades I and II were categorized as "easy laryngoscopy group", while grades III and IV were labeled "difficult laryngoscopy group". Demographic data, conventional bedside indicators including inter-incisor gap (IIG), neck circumference (NC), thyromental distance, the upper lip bite test (ULBT), and 4 radiological indicators including Mandibular Length, Laryngeal Height, the Larynx-Mandibular Angle Test (LMAT) and Larynx-Mandibular Height Test (LMHT) were analyzed comparatively. A binary logistic regression model was developed to identify independent predictive factors. The predictive value of the indicators was evaluated with the area under the curve (AUC).

Results: A total of 402 patients were analyzed in the present study. A binary logistic regression model identified IIG, NC, ULBT, and LMAT as the independent indicators associated with difficult laryngoscopy. A novel combined predictive model equation was derived: Ɩ=-0.969 - 1.33×IIG + 0.408×ULBT + 0.201×NC - 0.042×LMAT. The AUC for this composite model was 0.776, exceeding the individual AUC of 0.677 for LMHT.

Conclusion: LMHT and the novel combined predictive model incorporating LMAT are potentially valuable predictors for difficult laryngoscopy in patients with cervical spondylosis.

Trial registration: The study was registered at the Chinese Clinical Trial Registry (ChiCTR2200058361) on April 7, 2022.

预测颈椎病患者喉镜检查困难的影像学指标和一种新的联合预测模型:一项前瞻性队列研究。
背景:预测困难的喉镜检查是术前评估的关键,特别是对于颈椎病患者。放射学评估已成为改善气道管理安全的必要条件。本研究介绍了头部伸直位侧位颈椎x线的新放射学指标,以提高预测喉镜检查困难的准确性。方法:一项前瞻性队列研究包括422例计划择期颈椎手术的患者。Cormack-Lehane分级1级和2级为“易喉镜组”,分级3级和4级为“难喉镜组”。对人口统计学资料、常规床边指标(门牙间隙、颈围、甲状腺距离)、上唇咬合试验(ULBT)、下颌骨长度、喉高、喉-下颌角试验(LMAT)、喉-下颌高度试验(LMHT)等4项影像学指标进行比较分析。建立了二元逻辑回归模型来识别独立的预测因素。采用曲线下面积(AUC)评价指标的预测价值。结果:本研究共分析402例患者。二元logistic回归模型确定IIG、NC、ULBT和LMAT为与喉镜检查困难相关的独立指标。推导出新的组合预测模型方程:Ɩ=-0.969 - 1.33×IIG + 0.408×ULBT + 0.201×NC - 0.042×LMAT。该复合模型的AUC为0.776,超过了LMHT的个体AUC(0.677)。结论:LMHT和LMAT联合预测模型对颈椎病患者喉镜检查困难有潜在的预测价值。试验注册:该研究已于2022年4月7日在中国临床试验注册中心注册(ChiCTR2200058361)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Anesthesiology
BMC Anesthesiology ANESTHESIOLOGY-
CiteScore
3.50
自引率
4.50%
发文量
349
审稿时长
>12 weeks
期刊介绍: BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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