Baby Aneeta Elizabeth, D'souza Moses Charles, Krishnakumar Mathangi, Kavalakkatt Dicin Davis
Department of Anaesthesia, St John's Medical College Hospital, Bengaluru, Karnataka, India.
Surgical and Neuro Intensive Care Unit, Department of Anaesthesia, St John's Medical College Hospital, Bengaluru, Karnataka, India.
Indian J Anaesth. 2024 Nov;68(11):1003-1009. doi: 10.4103/ija.ija_474_24. Epub 2024 Oct 26.
El-Ganzouri risk index (EGRI) scoring is a predictive tool for difficult video laryngoscope (VL) guided tracheal intubation, and its use has been studied for various VLs. This study evaluates the predictive value of EGRI scoring for difficult laryngoscopy and tracheal intubation with King Vision VL.
Airway assessment was performed preinduction using the EGRI score. Following induction, initial laryngeal visualisation with a Macintosh blade identified the Cormack-Lehane grade. Final laryngoscopy and tracheal intubation were done using the King Vision VL, assessing the view with Percentage of Glottic Opening (POGO), Fremantle scores and ease with the modified Intubation Difficulty Scale. EGRI's predictive power was evaluated through statistical analyses using Chi-square, -test and receiver operating characteristic (ROC) curve. Statistical Package for the Social Sciences version 21.0 was used for analysis.
A total of 250 patients were included in the study, and the cut-off value of EGRI was 4. EGRI was assessed using the POGO and Fremantle scores for the view obtained during VL. The optimal cut-off for EGRI score was 3. ROC for difficult airways was calculated and compared to other scores. Sensitivity, specificity and area under the curve (AUC) were 82%, 86% and 0.9, respectively, for the POGO score and 74%, 92% and 0.85, respectively, for the Fremantle score. The ease of tube placement when assessed using a modified intubation difficulty scale was evaluated, and the sensitivity, specificity and AUC values were 95%, 86% and 0.94, respectively.
EGRI scoring can effectively predict difficult laryngoscopy and intubation with the King Vision video laryngoscope.
埃尔 - 甘祖里风险指数（EGRI）评分是一种用于预测困难视频喉镜引导气管插管的工具，其在各种视频喉镜中的应用已得到研究。本研究评估EGRI评分对使用可视喉镜进行困难喉镜检查和气管插管的预测价值。
诱导前使用EGRI评分进行气道评估。诱导后，使用麦金托什喉镜叶片进行初始喉镜可视化，确定科马克 - 莱汉内分级。使用可视喉镜进行最终喉镜检查和气管插管，通过声门开口百分比（POGO）、弗里曼特尔评分以及改良插管难度量表评估视野情况。通过卡方检验、t检验和受试者工作特征（ROC）曲线进行统计分析，评估EGRI的预测能力。使用社会科学统计软件包第21.0版进行分析。
本研究共纳入250例患者，EGRI的临界值为4。使用POGO和弗里曼特尔评分评估可视喉镜检查期间获得的视野来评估EGRI。EGRI评分的最佳临界值为3。计算困难气道的ROC并与其他评分进行比较。POGO评分的敏感性、特异性和曲线下面积（AUC）分别为82%、86%和0.9，弗里曼特尔评分的敏感性、特异性和AUC分别为74%、92%和0.85。使用改良插管难度量表评估导管置入的难易程度，敏感性、特异性和AUC值分别为95%、86%和0.94。
EGRI评分可以有效预测使用可视喉镜进行困难喉镜检查和插管的情况。
