Comparison of Cormack-Lehane and Mallampati scores to predict difficult intubation in patients undergoing emergency surgery under general anesthesia

Abstract

Introduction. Adequate management of the airway is vital in the context of cardiorespiratory complications in general anesthesia. Objective. We compared Mallampati and Cormack-Lehane scores for difficult intubation in emergency surgery patients undergoing general anesthesia at Carlos Andrade Marín Specialties Hospital, between March and May 2017. Materials and Methods. We conducted a cross-sectional study in a sample of 281 patients, to whom we comparatively applied Mallampati and Cormack-Lehane scores and assessed predictive values. Variables were expressed with measures of central
tendency and dispersion. Both scores were correlated via κ coefficient. Values p <0.05 were accepted as significant. Results. The Mallampati scale had a sensitivity of 62.5%, a specificity of 78.8%, and positive predictive value of 7.9% and negative predictive value of 98.6%. The positive likelihood was = 1.6 and the negative likelihood = 0.48. The Cormack scores presented a sensitivity of 80.3% and a specificity of 50%, a positive predictive value of 12% and a negative predictive value of 96.7%. The likelihood ratio was LR+ = 2.94 and LR- = 0.001. Cohens’ κ between Mallampati and Cormack-Lehane scores was = 0.51. All patients who registered Cormack-Lehane grades III and IV had a difficult intubation with a statistically significant association (p <0.01) and a 4.8 risk increase (OR: 4.89 CI: 2.00-11.95) between grade III and IV Cormack-Lehane and grade III and IV Mallampati scores. Conclusions. Cormack-Lehane and Mallampati scores have clinical utility as predictors of difficult intubation.