Acromioaxillosuprasternal notch index(AASI)Versus Traditional Airway Parameters In Predicting Difficult Visualisation Of Larynx - An Observational Study
Keywords:
Difficult laryngoscopy, Acromio Axillo Suprasternal notch index (AASI), Airway assessment, Cormack-Lehane gradingAbstract
Background: Predicting difficult laryngoscopy remains a challenge in anesthesia. The acromio axillo suprasternal notch index (AASI) is a novel, objective test designed for this purpose.
AIM: To assess the diagnostic accuracy of AASI in predicting difficult laryngoscopy and compare its performance with other conventional airway predictors: Modified Mallampati Grading (MPG), Sternomental Distance (SMD), and Thyromental Distance (TMD).
Methods: This prospective, observational, double-blinded study included 150 patients undergoing elective surgeries under general anesthesia. Preoperative airway assessment included AASI, MPG, TMD, and SMD. The Cormack-Lehane (CL) grading was assessed during direct laryngoscopy. Statistical analysis was performed using ROC curves, sensitivity, specificity, PPV, and NPV calculations.
Results: The incidence of difficult visualization of larynx (CL grade 3 & 4) was 33.3%. AASI showed the highest sensitivity (93.3%) and specificity (91.2%) at a cutoff value of >0.49. AUC for AASI was 0.933, outperforming MPG (AUC = 0.765), TMD (AUC = 0.702), and SMD (AUC = 0.728).
Conclusion: AASI is a superior predictor for difficult laryngoscopy compared to MPG, TMD, and SMD, offering a simple, reliable, and objective tool, especially useful in supine or uncooperative patients.
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Shilpa acharya, shalini sardesai, pritam chavan and vinod holkar (2021); acromio axillo-suprasternal notch index [AASI] : a screening method to predict difficult laryngoscopy in patient undergoing general anaesthesia and requiring endotracheal intubation int. j. of adv. res. 9 (oct). 717-721]
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