A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care Centre
Introduction: Airway management is sometimes difficult and it remains a significant reason for anaesthesia-related morbidity and mortality. Cardiac surgical patients, due to comorbidities and anatomical challenges, are thought to be at higher risk of intubation difficulties. However, limited Indian...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
National Board of Examinations
2025-08-01
|
| Series: | National Board of Examinations Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://natboard.edu.in/ejournal/articledtl?x=VEJyUnRBaWR0RXpnelRwczYvdld2Zz09 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849343657420783616 |
|---|---|
| author | Jones Deepan Kumar Sudarsan Kasthuri Kaapian Thamizholi Amar Nandakumar Jeevithan Shanmugam |
| author_facet | Jones Deepan Kumar Sudarsan Kasthuri Kaapian Thamizholi Amar Nandakumar Jeevithan Shanmugam |
| author_sort | Jones Deepan Kumar |
| collection | DOAJ |
| description | Introduction: Airway management is sometimes difficult and it remains a significant reason for anaesthesia-related morbidity and mortality. Cardiac surgical patients, due to comorbidities and anatomical challenges, are thought to be at higher risk of intubation difficulties. However, limited Indian data exist comparing the incidence and prevalence of difficult intubation between cardiac and other surgical patients. The current research aims at assessment and comparison of the incidence and predictors of difficult intubation in these two patient groups. Materials and Methods: A prospective observational study was conducted at a tertiary care centre over a six-month period. Under general anaesthesia 400 patients aged over 40 years undergoing elective or emergency cardiac and non-cardiac surgeries (others) were involved. Results: Among the 400 patients (200 in each group), difficult intubation (IDS >5) was observed in 19.5% of cardiac patients compared to 3% in non-cardiac patients (p<0.001). Cardiac patients had significantly higher BMI, Mallampati scores, and neck circumference, with lower thyromental measurements. Hypertension and BMI were significantly associated with higher IDS in cardiac patients. Most airway assessment parameters statistically significant differences between the two groups (p<0.001). Conclusion: Patients who had undergone cardiac surgeries are at a significantly higher risk for difficult intubation. Preoperative identification of high-risk patients using a combination of bedside airway assessments is essential. The Intubation Difficulty Scale is a useful parameter for quantifying intubation complexity in clinical practice. |
| format | Article |
| id | doaj-art-9d66a4231bce4fb0bbc73591ccddc2aa |
| institution | Kabale University |
| issn | 2583-7524 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | National Board of Examinations |
| record_format | Article |
| series | National Board of Examinations Journal of Medical Sciences |
| spelling | doaj-art-9d66a4231bce4fb0bbc73591ccddc2aa2025-08-20T03:42:53ZengNational Board of ExaminationsNational Board of Examinations Journal of Medical Sciences2583-75242025-08-013894194910.61770/NBEJMS.2025.v03.i08.006A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care CentreJones Deepan Kumar0Sudarsan Kasthuri1Kaapian Thamizholi2Amar Nandakumar3Jeevithan Shanmugam4Consultant anaesthetist, Sri Kumaran Hospital, TirupurAssociate Professor in Anesthesiology, KMCH Institute of Health Sciences and Research, Coimbatore – 14Consultant Anesthesiologist, KMCH Institute of Health Sciences and Research, Coimbatore – 14Consultant Anesthesiologist, KMCH Institute of Health Sciences and Research, Coimbatore – 14Professor in Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore – 14Introduction: Airway management is sometimes difficult and it remains a significant reason for anaesthesia-related morbidity and mortality. Cardiac surgical patients, due to comorbidities and anatomical challenges, are thought to be at higher risk of intubation difficulties. However, limited Indian data exist comparing the incidence and prevalence of difficult intubation between cardiac and other surgical patients. The current research aims at assessment and comparison of the incidence and predictors of difficult intubation in these two patient groups. Materials and Methods: A prospective observational study was conducted at a tertiary care centre over a six-month period. Under general anaesthesia 400 patients aged over 40 years undergoing elective or emergency cardiac and non-cardiac surgeries (others) were involved. Results: Among the 400 patients (200 in each group), difficult intubation (IDS >5) was observed in 19.5% of cardiac patients compared to 3% in non-cardiac patients (p<0.001). Cardiac patients had significantly higher BMI, Mallampati scores, and neck circumference, with lower thyromental measurements. Hypertension and BMI were significantly associated with higher IDS in cardiac patients. Most airway assessment parameters statistically significant differences between the two groups (p<0.001). Conclusion: Patients who had undergone cardiac surgeries are at a significantly higher risk for difficult intubation. Preoperative identification of high-risk patients using a combination of bedside airway assessments is essential. The Intubation Difficulty Scale is a useful parameter for quantifying intubation complexity in clinical practice.https://natboard.edu.in/ejournal/articledtl?x=VEJyUnRBaWR0RXpnelRwczYvdld2Zz09difficult intubationcardiac anaesthesiaintubation difficulty scaleairway assessmentpredictive factors |
| spellingShingle | Jones Deepan Kumar Sudarsan Kasthuri Kaapian Thamizholi Amar Nandakumar Jeevithan Shanmugam A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care Centre National Board of Examinations Journal of Medical Sciences difficult intubation cardiac anaesthesia intubation difficulty scale airway assessment predictive factors |
| title | A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care Centre |
| title_full | A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care Centre |
| title_fullStr | A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care Centre |
| title_full_unstemmed | A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care Centre |
| title_short | A Prospective Comparative Study on the Incidence and Predictors of Difficult Intubation in Cardiac Versus Non-Cardiac Surgical Patients in a Tertiary Care Centre |
| title_sort | prospective comparative study on the incidence and predictors of difficult intubation in cardiac versus non cardiac surgical patients in a tertiary care centre |
| topic | difficult intubation cardiac anaesthesia intubation difficulty scale airway assessment predictive factors |
| url | https://natboard.edu.in/ejournal/articledtl?x=VEJyUnRBaWR0RXpnelRwczYvdld2Zz09 |
| work_keys_str_mv | AT jonesdeepankumar aprospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT sudarsankasthuri aprospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT kaapianthamizholi aprospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT amarnandakumar aprospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT jeevithanshanmugam aprospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT jonesdeepankumar prospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT sudarsankasthuri prospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT kaapianthamizholi prospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT amarnandakumar prospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre AT jeevithanshanmugam prospectivecomparativestudyontheincidenceandpredictorsofdifficultintubationincardiacversusnoncardiacsurgicalpatientsinatertiarycarecentre |