Predicting difficult intubation—a comparison between Mallampati classification and Wilson risk-sum

Rashad Siddiqi, Waqas Ahmed Kazi
Journal of the College of Physicians and Surgeons—Pakistan: JCPSP 2005, 15 (5): 253-6

OBJECTIVE: To compare the Mallampati classification and Wilson risk-sum and adopt a predictive rule in our setup that has better results.

DESIGN: An analytical study.

PLACE AND DURATION OF STUDY: The main Operation Theatre of Combined Military Hospital, Rawalpindi from 1st September to 31st December 2000.

PATIENTS AND METHODS: Three hundred and thirty-eight patients were evaluated pre-operatively for difficult intubation using both the tests. The sensitivities, specificities and positive predictive values (PPV) were determined in grading the laryngeal view in each case during direct laryngoscopy.

RESULTS: Both tests identified only 3 out of 7 difficult intubations, giving a similar sensitivity of 0.42. Twice as many patients were predicted to be difficult by Mallampati classification than by Wilson risk-sum (specificity 84% and 93%). The Wilson risk-sum had better positive predictive value (11%) as compared to 5% of Mallampati classification.

CONCLUSION: The Wilson risk-sum had preferred for assessment of the airway because of its better specificity and positive predictive value while noting that both tests have poor sensitivities when used alone.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"