Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database
Summary Both the American Society of Anesthesiologists and the UK NAP4 project recommend that an unspecified pre‐operative airway assessment be made. However, the choice of assessment is ultimately at the discretion of the individual anaesthesiologist. We retrieved a cohort of 188 064 cases from the...
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| Veröffentlicht in: | Anaesthesia 2015-03, Vol.70 (3), p.272-281 |
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| creator | Nørskov, A. K. Rosenstock, C. V. Wetterslev, J. Astrup, G. Afshari, A. Lundstrøm, L. H. |
| description | Summary
Both the American Society of Anesthesiologists and the UK NAP4 project recommend that an unspecified pre‐operative airway assessment be made. However, the choice of assessment is ultimately at the discretion of the individual anaesthesiologist. We retrieved a cohort of 188 064 cases from the Danish Anaesthesia Database, and investigated the diagnostic accuracy of the anaesthesiologists’ predictions of difficult tracheal intubation and difficult mask ventilation. Of 3391 difficult intubations, 3154 (93%) were unanticipated. When difficult intubation was anticipated, 229 of 929 (25%) had an actual difficult intubation. Likewise, difficult mask ventilation was unanticipated in 808 of 857 (94%) cases, and when anticipated (218 cases), difficult mask ventilation actually occurred in 49 (22%) cases. We present a previously unpublished estimate of the accuracy of anaesthesiologists’ prediction of airway management difficulties in daily routine practice. Prediction of airway difficulties remains a challenging task, and our results underline the importance of being constantly prepared for unexpected difficulties. |
| doi_str_mv | 10.1111/anae.12955 |
| format | Article |
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Both the American Society of Anesthesiologists and the UK NAP4 project recommend that an unspecified pre‐operative airway assessment be made. However, the choice of assessment is ultimately at the discretion of the individual anaesthesiologist. We retrieved a cohort of 188 064 cases from the Danish Anaesthesia Database, and investigated the diagnostic accuracy of the anaesthesiologists’ predictions of difficult tracheal intubation and difficult mask ventilation. Of 3391 difficult intubations, 3154 (93%) were unanticipated. When difficult intubation was anticipated, 229 of 929 (25%) had an actual difficult intubation. Likewise, difficult mask ventilation was unanticipated in 808 of 857 (94%) cases, and when anticipated (218 cases), difficult mask ventilation actually occurred in 49 (22%) cases. We present a previously unpublished estimate of the accuracy of anaesthesiologists’ prediction of airway management difficulties in daily routine practice. Prediction of airway difficulties remains a challenging task, and our results underline the importance of being constantly prepared for unexpected difficulties.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/anae.12955</identifier><identifier>PMID: 25511370</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Airway management ; Airway Management - methods ; Airway Management - statistics & numerical data ; Anesthesia ; Anesthesiology - statistics & numerical data ; Cohort Studies ; Databases, Factual - statistics & numerical data ; Denmark ; Humans ; Intubation, Intratracheal - statistics & numerical data ; Medical diagnosis ; Odds Ratio ; Preoperative Care - methods ; Reproducibility of Results ; Sensitivity and Specificity</subject><ispartof>Anaesthesia, 2015-03, Vol.70 (3), p.272-281</ispartof><rights>2014 The Association of Anaesthetists of Great Britain and Ireland</rights><rights>2014 The Association of Anaesthetists of Great Britain and Ireland.</rights><rights>Copyright © 2015 The Association of Anaesthetists of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3905-2502b3ff6c1ec5524bf839a6fb3f6f2cb302444f8853ba6405b2870ed44ae59d3</citedby><cites>FETCH-LOGICAL-c3905-2502b3ff6c1ec5524bf839a6fb3f6f2cb302444f8853ba6405b2870ed44ae59d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fanae.12955$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fanae.12955$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25511370$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nørskov, A. K.</creatorcontrib><creatorcontrib>Rosenstock, C. V.</creatorcontrib><creatorcontrib>Wetterslev, J.</creatorcontrib><creatorcontrib>Astrup, G.</creatorcontrib><creatorcontrib>Afshari, A.</creatorcontrib><creatorcontrib>Lundstrøm, L. H.</creatorcontrib><title>Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
Both the American Society of Anesthesiologists and the UK NAP4 project recommend that an unspecified pre‐operative airway assessment be made. However, the choice of assessment is ultimately at the discretion of the individual anaesthesiologist. We retrieved a cohort of 188 064 cases from the Danish Anaesthesia Database, and investigated the diagnostic accuracy of the anaesthesiologists’ predictions of difficult tracheal intubation and difficult mask ventilation. Of 3391 difficult intubations, 3154 (93%) were unanticipated. When difficult intubation was anticipated, 229 of 929 (25%) had an actual difficult intubation. Likewise, difficult mask ventilation was unanticipated in 808 of 857 (94%) cases, and when anticipated (218 cases), difficult mask ventilation actually occurred in 49 (22%) cases. We present a previously unpublished estimate of the accuracy of anaesthesiologists’ prediction of airway management difficulties in daily routine practice. Prediction of airway difficulties remains a challenging task, and our results underline the importance of being constantly prepared for unexpected difficulties.</description><subject>Airway management</subject><subject>Airway Management - methods</subject><subject>Airway Management - statistics & numerical data</subject><subject>Anesthesia</subject><subject>Anesthesiology - statistics & numerical data</subject><subject>Cohort Studies</subject><subject>Databases, Factual - statistics & numerical data</subject><subject>Denmark</subject><subject>Humans</subject><subject>Intubation, Intratracheal - statistics & numerical data</subject><subject>Medical diagnosis</subject><subject>Odds Ratio</subject><subject>Preoperative Care - methods</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks1u1DAUhS0EotPChgdAltggpCm2YzsOu1FbfqQKNrCObhx7xpUTD7ajKjtegx3PgvokPAlOp3TBAryxdPWdc499L0LPKDml5byGEcwpZY0QD9CKVlKsGeH8IVoRQqo146Q5QscpXRFCmaLqMTpiQlBa1WSFbs4dbMeQstMYtJ4i6BkHixfPlHcmueDD1qWcfn37jvfR9E5nF8aF6Z21Tk8-Y3DxGmY8FNXWDGbM2I24B-dnrL0bnQZftFCU2rzBgHXYhZhxylN_240q9fMHkRzvIbsiTziapakp_RarEgSfw-jSDm_ug0EpZeggmSfokQWfzNO7-wR9eXvx-ez9-vLTuw9nm8u1rhpSfkUQ1lXWSk2NFoLxzqqqAWlLUVqmu4owzrlVSlQdSE5Ex1RNTM85GNH01Ql6efDdx_B1KjHawSVtvIfRhCm1VDVUyZrR-v-oFKJmkteyoC_-Qq_CFMfykIXidaNoowr16kDpGFKKxrb76AaIc0tJu6xBu4ysvV2DAj-_s5y6wfT36J-5F4AegGvnzfwPq3bzcXNxMP0NZJfA7Q</recordid><startdate>201503</startdate><enddate>201503</enddate><creator>Nørskov, A. K.</creator><creator>Rosenstock, C. V.</creator><creator>Wetterslev, J.</creator><creator>Astrup, G.</creator><creator>Afshari, A.</creator><creator>Lundstrøm, L. H.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201503</creationdate><title>Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database</title><author>Nørskov, A. K. ; Rosenstock, C. V. ; Wetterslev, J. ; Astrup, G. ; Afshari, A. ; Lundstrøm, L. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3905-2502b3ff6c1ec5524bf839a6fb3f6f2cb302444f8853ba6405b2870ed44ae59d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Airway management</topic><topic>Airway Management - methods</topic><topic>Airway Management - statistics & numerical data</topic><topic>Anesthesia</topic><topic>Anesthesiology - statistics & numerical data</topic><topic>Cohort Studies</topic><topic>Databases, Factual - statistics & numerical data</topic><topic>Denmark</topic><topic>Humans</topic><topic>Intubation, Intratracheal - statistics & numerical data</topic><topic>Medical diagnosis</topic><topic>Odds Ratio</topic><topic>Preoperative Care - methods</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nørskov, A. K.</creatorcontrib><creatorcontrib>Rosenstock, C. V.</creatorcontrib><creatorcontrib>Wetterslev, J.</creatorcontrib><creatorcontrib>Astrup, G.</creatorcontrib><creatorcontrib>Afshari, A.</creatorcontrib><creatorcontrib>Lundstrøm, L. H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nørskov, A. K.</au><au>Rosenstock, C. V.</au><au>Wetterslev, J.</au><au>Astrup, G.</au><au>Afshari, A.</au><au>Lundstrøm, L. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2015-03</date><risdate>2015</risdate><volume>70</volume><issue>3</issue><spage>272</spage><epage>281</epage><pages>272-281</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><abstract>Summary
Both the American Society of Anesthesiologists and the UK NAP4 project recommend that an unspecified pre‐operative airway assessment be made. However, the choice of assessment is ultimately at the discretion of the individual anaesthesiologist. We retrieved a cohort of 188 064 cases from the Danish Anaesthesia Database, and investigated the diagnostic accuracy of the anaesthesiologists’ predictions of difficult tracheal intubation and difficult mask ventilation. Of 3391 difficult intubations, 3154 (93%) were unanticipated. When difficult intubation was anticipated, 229 of 929 (25%) had an actual difficult intubation. Likewise, difficult mask ventilation was unanticipated in 808 of 857 (94%) cases, and when anticipated (218 cases), difficult mask ventilation actually occurred in 49 (22%) cases. We present a previously unpublished estimate of the accuracy of anaesthesiologists’ prediction of airway management difficulties in daily routine practice. Prediction of airway difficulties remains a challenging task, and our results underline the importance of being constantly prepared for unexpected difficulties.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25511370</pmid><doi>10.1111/anae.12955</doi><tpages>10</tpages></addata></record> |
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| subjects | Airway management Airway Management - methods Airway Management - statistics & numerical data Anesthesia Anesthesiology - statistics & numerical data Cohort Studies Databases, Factual - statistics & numerical data Denmark Humans Intubation, Intratracheal - statistics & numerical data Medical diagnosis Odds Ratio Preoperative Care - methods Reproducibility of Results Sensitivity and Specificity |
| title | Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database |
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