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学科主题临床医学
Application of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for cervical spondylosis
Xu Mao1; Li Xiaoxi2; Wang Jun1; Guo Xiangyang1
关键词intubation cervical spondylosis statistical model
刊名CHINESE MEDICAL JOURNAL
2014-12-05
DOI10.3760/cma.j.issn.0366-6999.20141345
127期:23页:4043-4048
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]LARYNGOSCOPY ; INTUBATION ; MANAGEMENT ; PERFORMANCE
英文摘要

Background Airway management is crucial in clinical anesthesia. Many complications associated with airway management result from unexpected difficult airway, but predicting a difficult airway is a major challenge. We investigated the efficacy of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for cervical spondylosis, a population with a high incidence of difficult airway.

Methods We randomly enrolled 303 patients scheduled for elective surgery for cervical spondylosis at Peking University Third Hospital between August 2012 and March 2013. Preoperatively, patients were evaluated for difficult airway according to a clinical index and parameters on lateral cervical radiographs and magnetic resonance images. Difficult airway was defined as Cormack-Lehane grades Logistic regression was used to identify a combined (clinical and radiological) model for difficult airway. A receiver operating characteristic (ROC) curve was used to describe the effectiveness of prediction.

Results We identified three clinical predictive factors using the ROC curve: mouth opening, sternomental distance, and neck mobility. We created a clinical model using three factors: gender, age, and mouth opening, with odds ratios (OR) of 0.370, 1.034, and 0.358, respectively. Using the clinical and radiological parameters, we formulated a combined model with five risk factors: gender, mouth opening, atlanto-occipital gap, the angle from the second to sixth cervical vertebraes in the neutral position, and the angle difference of delta (the angle between the laryngeal axis and the epiglottic axis) from the neutral position to extension (OR: 0.107, 0.355, 0.846, 1.057, and 0.952, respectively). The sensitivity and specificity of the combined model were 80.0% and 65.7%, respectively, and the ROC curve confirmed that the combined model was better than any single clinical predictor and the clinical model.

Conclusion The efficacy of the combined model including both clinical and radiological indicators was better than any single clinical predictor or the clinical model in patients undergoing elective surgery for cervical spondylosis.

语种英语
WOS记录号WOS:000347276500008
项目编号BYSY2014019
资助机构Peking University Third Hospital
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/62448
专题北京大学第三临床医学院_麻醉科
作者单位1.Peking Univ, Hosp 3, Dept Anesthesiol, Beijing 100191, Peoples R China
2.Beijing Canc Hosp & Inst, Dept Anesthesiol, Beijing 100142, Peoples R China
推荐引用方式
GB/T 7714
Xu Mao,Li Xiaoxi,Wang Jun,et al. Application of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for cervical spondylosis[J]. CHINESE MEDICAL JOURNAL,2014,127(23):4043-4048.
APA Xu Mao,Li Xiaoxi,Wang Jun,&Guo Xiangyang.(2014).Application of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for cervical spondylosis.CHINESE MEDICAL JOURNAL,127(23),4043-4048.
MLA Xu Mao,et al."Application of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for cervical spondylosis".CHINESE MEDICAL JOURNAL 127.23(2014):4043-4048.
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