Dyrbuś Maciej, Oraczewska Aleksandra, Szmigiel Szymon, Gawęda Szymon, Kluszczyk Paulina, Cyzowski Tomasz, Jędrzejek Marek, Dubik Paweł, Kozłowski Michał, Kwiatek Sebastian, Celińska Beata, Wita Michał, Trejnowska Ewa, Swinarew Andrzej, Darocha Tomasz, Barczyk Adam, Skoczyński Szymon
Pyrzowice Temporary Hospital, Leszek Giec Upper-Silesian Medical Center, 40-635 Katowice, Poland.
3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland.
J Clin Med. 2022 May 24;11(11):2958. doi: 10.3390/jcm11112958.
Mallampati score has been identified and accepted worldwide as an independent predictor of difficult intubation and obstructive sleep apnea. We aimed to determine whether Mallampati score assessed on the first patient medical assessment allowed us to stratify the risk of worsening of conditions in patients hospitalized due to COVID-19. A total of 493 consecutive patients admitted between 13 November 2021 and 2 January 2022 to the temporary hospital in Pyrzowice were included in the analysis. The clinical data, chest CT scan, and major, clinically relevant laboratory parameters were assessed by patient-treating physicians, whereas the Mallampati score was assessed on admission by investigators blinded to further treatment. The primary endpoints were necessity of active oxygen therapy (AOT) during hospitalization and 60-day all-cause mortality. Of 493 patients included in the analysis, 69 (14.0%) were in Mallampati I, 57 (11.6%) were in Mallampati II, 78 (15.8%) were in Mallampati III, and 288 (58.9%) were in Mallampati IV. There were no differences in the baseline characteristics between the groups, except the prevalence of chronic kidney disease (p = 0.046). Patients with Mallampati IV were at the highest risk of AOT during the hospitalization (33.0%) and the highest risk of death due to any cause at 60 days (35.0%), which significantly differed from other scores (p = 0.005 and p = 0.03, respectively). Mallampati IV was identified as an independent predictor of need for AOT (OR 3.089, 95% confidence interval 1.65−5.77, p < 0.001) but not of all-cause mortality at 60 days. In conclusion, Mallampati IV was identified as an independent predictor of AOT during hospitalization. Mallampati score can serve as a prehospital tool allowing to identify patients at higher need for AOT.
Mallampati评分已被全球公认为困难插管和阻塞性睡眠呼吸暂停的独立预测指标。我们旨在确定在患者首次医学评估时所评估的Mallampati评分是否能让我们对因COVID-19住院患者病情恶化的风险进行分层。2021年11月13日至2022年1月2日期间连续收治到皮尔佐维采临时医院的493例患者纳入分析。临床数据、胸部CT扫描以及主要的、临床相关的实验室参数由负责治疗的医生进行评估，而Mallampati评分由对进一步治疗不知情的研究人员在入院时进行评估。主要终点为住院期间积极氧疗（AOT）的必要性和60天全因死亡率。在纳入分析的493例患者中，69例（14.0%）为Mallampati I级，57例（11.6%）为Mallampati II级，78例（15.8%）为Mallampati III级，288例（58.9%）为Mallampati IV级。除慢性肾脏病患病率外（p = 0.046），各组间基线特征无差异。Mallampati IV级患者住院期间AOT风险最高（33.0%），60天任何原因导致的死亡风险最高（35.0%），这与其他评分有显著差异（分别为p = 0.005和p = 0.03）。Mallampati IV级被确定为AOT需求的独立预测指标（比值比3.089，95%置信区间1.65 - 5.77，p < 0.001），但不是60天全因死亡率的独立预测指标。总之，Mallampati IV级被确定为住院期间AOT的独立预测指标。Mallampati评分可作为一种院前工具，用于识别更需要AOT的患者。
