Population analysis of predictors of difficult intubation with direct laryngoscopy in pediatric patients with and without thyroid disease

Purpose There are no data on the prevalence and predictors of difficult intubation (DI) in pediatric patients with thyroid disease. This study (1) assesses the prevalence of DI in patients with thyroid disease undergoing elective operations, (2) identifies other predictors of DI in children, and (3)...

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Bibliographic Details
Published in:Journal of anesthesia 2018-02, Vol.32 (1), p.54-61
Main Authors: Shah, Aalap C., Ng, William C. K., Sinnott, Sean, Cravero, Joseph P.
Format: Article
Language:English
Subjects:
Analysis
Anesthesiology
Comparative analysis
Complications and side effects
Critical Care Medicine
Emergency Medicine
Health aspects
Intensive
Intubation
Laryngoscopy
Medicine
Medicine & Public Health
Original Article
Pain Medicine
Patient care
Patient outcomes
Pediatrics
Risk factors
Thyroid diseases
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Summary:Purpose There are no data on the prevalence and predictors of difficult intubation (DI) in pediatric patients with thyroid disease. This study (1) assesses the prevalence of DI in patients with thyroid disease undergoing elective operations, (2) identifies other predictors of DI in children, and (3) evaluates the effect of DI on postoperative care and length-of-stay. Methods A single-center retrospective cohort analysis of procedures in patients assigned with an ICD-9 code for thyroid disease between June 2012 and February 2016. A comparative group was created which comprised of patients without thyroid disease receiving orthopedic or urologic surgeries to determine differences in DI prevalence. Univariate analyses compared demographics and intubation details between groups, and logistic regression identified independent variables associated with DI. Patients with and without DI were compared based on procedure duration, PACU-LOS, and escalation-of-care. Results DI prevalence was greater in the thyroid group (4.9%, 51/1046) compared to the non-thyroid group (2.6%, 33/1289) (OR 1.95, 95% CI 1.25–3.05; p  = 0.003). DI was associated with younger age, higher American Society of Anesthesiologists (ASA) class, and smaller body habitus ( p  
ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-017-2428-x