Bedside tests for predicting difficult airways: an abridged Cochrane diagnostic test accuracy systematic review.

摘要: Although bedside screening tests are routinely used to identify people at high risk of having a difficult airway, their clinical utility is unclear. We estimated the diagnostic accuracy commonly examination for assessing airway in adult patients without apparent anatomical abnormalities scheduled undergo general anaesthesia. searched studies that reported our pre-specified index against reference standard, published any language, from date inception 16 December 2016, seven bibliographic databases. included 133 (127 cohort type and 6 case–control) involving 844,206 participants. Overall, methodological quality (according QUADAS-2, standard tool studies) was moderate high. Our were: Mallampati test (6 studies); modified (105 Wilson score thyromental distance (52 sternomental (18 mouth opening (34 upper lip bite (30 studies). Difficult facemask ventilation, laryngoscopy, intubation failed were standards seven, 92, 50 two studies, respectively. Across all standards, we found had relatively low sensitivities, with variability, but specificities consistently markedly higher than sensitivities. For sensitivity specificity (95%CI) 0.67 (0.45–0.83) 0.92 (0.86–0.95), respectively; significantly (0.22, 0.13–0.33; p < 0.001). tracheal intubation, 0.51 (0.40–0.61) compared (0.27, 0.16–0.41; 0.001) (0.24, 0.12–0.43; showed most favourable properties, none common well suited detecting unanticipated airways, as many them missed. (Less)