Clinical Criteria for Airway Assessment: Correlations with Laryngoscopy and Endotracheal Intubation Conditions
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Since the Wilson score takes various factors and ana-
tomical characteristics into consideration rather than just
one as in the case of the Mallampati classification, sensi-
tivity and specificity tend to be higher. Moreover, the
characteristics evaluated are well defined and well de-
scribed, leaving less margin for subjectivity during the
exam. This brings the various studies closer methodol-
ogically, ensuring that the results are in general compa-
rable.
Some limitations of the present study must be men-
tioned. The total number of patients in the sample (81) is
considered small for a study involving events that are
relatively rare in the general population such as the case
of a difficult airway. This may have been responsible for
the lack of statistical significance in some of our results.
Since this is a teaching and training institute for anesthe-
siologists, most of the data were collected by trainee
physicians. Nevertheless, although data were collected
by different individuals throughout the study period, all
were duly trained for this function by the authors. Be-
cause the intubations were performed by resident physi-
cians, the number of attempts recorded may have been
less in some cases if the procedure had been performed
by an experienced anesthesiologist. It should be empha-
sized that in the patient in whom intubation was unsuc-
cessful by conventional laryngoscopy, the anesthesiolo-
gist responsible for the case also failed to intubate the
patient and was obliged to resort to the use of a gum
elastic bougie to successfully conclude the procedure.
The present study concludes that the Wilson score,
despite being seldom used in clinical practice, is a highly
sensitive predictor of a difficult airway, although its
specificity is low. Further studies with larger sample
sizes are required to confirm these findings and to obtain
statistically significant results for the other indexes eva-
luated.
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