Predictive value of the El-Ganzouri multivariate risk index for difficult tracheal intubation: A comparison of Glidescope® videolaryngoscopy and conventional Macintosh laryngoscopy

P. Cortellazzi, L. Minati, C. Falcone, M. Lamperti, D. Caldiroli

Research output: Contribution to journalArticle

Abstract

Background. The predictive value of the El-Ganzouri risk index (EGRI) for difficult intubation has been evaluated using Macintosh laryngoscopy as reference standard. The Glidescope® videolaryngoscope provides improved visualization of the glottis. We studied the predictive value of the EGRI using videolaryngoscopy as reference standard. Methods. Data from two subsequent groups of patients, intubated with Macintosh laryngoscopy (ML, n = 994) and videolaryngoscopy (VL, n = 843), were retrospectively analysed. The EGRI was taken as index test. The two types of laryngoscopy were adopted as reference for the presence of Cormack and Lehane grading III-IV. For both groups, sensitivity, specificity, and positive and negative post-test probabilities (PTP) were calculated for thresholds on the EGRI scale. Receiver operating characteristic curves and corresponding areas (AUC) were obtained. Results. Sensitivity and specificity were 69.7% and 66.3% at the cut-off value of 2 in the ML group, and 93.3% and 76.6% at the cut-off value of 3 in the VL group. Corresponding positive and negative PTP were 12.81% and 3.15% in the ML group, and 6.73% and 0.16% in the VL group. At the threshold of 4, positive and negative PTP were 31.34% and 4.85% in the ML group. At the threshold of 7, positive and negative PTP were 85.71% and 1.08% in the VL group. The AUC was 0.74 in the ML group and 0.91 in the VL group. Conclusions. The predictive value of the EGRI may have been underestimated due to limited accuracy of Macintosh laryngoscopy. Using videolaryngoscopy, the EGRI might be reconsidered as a decisional tool.

Original languageEnglish
Pages (from-to)906-911
Number of pages6
JournalBritish Journal of Anaesthesia
Volume99
Issue number6
DOIs
Publication statusPublished - Dec 2007

Keywords

  • Complications, intubation tracheal
  • Equipment, laryngoscopes
  • Larynx, laryngoscopy
  • Risk

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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