Calin Mitre1, Ileana Mitre2, Zoltán Gyöngyösi3, Béla Fülesdi3, Claudiu Zdrehus1, Caius Breazu1, Peter Biro4. 1. Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. 2. Department of Anesthesiology for Buco Maxillo-Facial Surgery, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. 3. Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary. 4. Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
Abstract
OBJECTIVE: The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties. METHODS: This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management. An intra-operative team of evaluators (team B) working independently of team A, performed the actual instrumentation of the airway and scored the actual findings. Both teams used the FRONT scoring system and worked independently of each other to ensure blinded assessments. The statistical analysis of the pre- and intra-operative FRONT scores was performed in an off-line blinded manner. RESULTS: Our results show a fair and promising association between pre-operative composite FRONT score and that observed at the induction phase (Spearman=0.43). Among the score components, the best correlation was observed for the F and R components (kappa=0.44 and 0.36, respectively), and the worse correlation was observed for the O and T components (kappa=0.25 and 0.24, respectively). CONCLUSION: The FRONT formula for the prediction and documentation of the airway status is a simple and effective method for assessing and defining airway management difficulties. Further prospective studies are required to assess the sensitivity and specificity of the system.
OBJECTIVE: The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties. METHODS: This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management. An intra-operative team of evaluators (team B) working independently of team A, performed the actual instrumentation of the airway and scored the actual findings. Both teams used the FRONT scoring system and worked independently of each other to ensure blinded assessments. The statistical analysis of the pre- and intra-operative FRONT scores was performed in an off-line blinded manner. RESULTS: Our results show a fair and promising association between pre-operative composite FRONT score and that observed at the induction phase (Spearman=0.43). Among the score components, the best correlation was observed for the F and R components (kappa=0.44 and 0.36, respectively), and the worse correlation was observed for the O and T components (kappa=0.25 and 0.24, respectively). CONCLUSION: The FRONT formula for the prediction and documentation of the airway status is a simple and effective method for assessing and defining airway management difficulties. Further prospective studies are required to assess the sensitivity and specificity of the system.
Entities:
Keywords:
Difficult airway; FRONT score; documentation of airway status; prediction of intubation
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