RESUMEN
Abstract Background and objectives: In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies. Methods: One hundred fifty-three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined. Results: A total of 25.4% of the patients had difficult intubations. SPIDS scores >10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT. Conclusions: The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.
Resumo Justificativa e objetivos: Neste estudo, avaliamos o valor preditivo de diferentes ferramentas de avaliação das vias aéreas, incluindo componentes do Escore Simplificado Preditivo de Intubação Difícil (ESPID), o próprio ESPID e a Medida da Altura Tireomentoniana (MATM), em intubações definidas como difícies pelo Escore de Dificuldade de Intubação (EDI) em um grupo de pacientes com patologia de cabeça e pescoço. Método: Incluímos no estudo 153 pacientes submetidos a cirurgia de cabeça e pescoço. Coletamos os resultados do Teste de Mallampati Modificado (TMM), Distância Tireomentoniana (DTM), Razão Altura/Distância Tireomentoniana (RADTM), MATM, amplitude máxima de movimentação da cabeça e pescoço e da abertura da boca. Os ESPIDs foram calculados e os EDIs, determinados. Resultados: Observamos intubação difícil em 25,4% dos pacientes. Os escores de ESPID > 10 tiveram sensibilidade de 86,27%, especificidade de 71,57% e valor preditivo negativo de 91,2% (VPN). O resultado da análise da curva de operação do receptor (curva ROC) para os testes de avaliação das vias aéreas e ESPID mostrou que o ESPID tinha a maior área sob a curva; no entanto, foi estatisticamente semelhante a outros testes, exceto para o TMM. Conclusões: O presente estudo demonstra o uso prático do ESPID na previsão da dificuldade de intubação em pacientes com patologia de cabeça e pescoço. O desempenho do ESPID na predição de via aérea difícil mostrou-se tão eficiente quanto os demais testes avaliados neste estudo. O ESPID pode ser considerado ferramenta abrangente e detalhada para prever via aérea difícil.
Asunto(s)
Humanos , Adulto , Anciano , Anciano de 80 o más Años , Adulto Joven , Intubación Intratraqueal/métodos , Cuello/cirugía , Disección del Cuello/estadística & datos numéricos , Glándula Tiroides/cirugía , Neoplasias de la Lengua/cirugía , Neoplasias Nasofaríngeas , Valor Predictivo de las Pruebas , Estudios Prospectivos , Curva ROC , Rango del Movimiento Articular , Sensibilidad y Especificidad , Evaluación de Resultado en la Atención de Salud , Avance Mandibular , Neoplasias de Cabeza y Cuello/cirugía , Intubación Intratraqueal/instrumentación , Laringectomía/estadística & datos numéricos , Traumatismos Maxilofaciales/cirugía , Persona de Mediana Edad , Boca/fisiología , Cuello/anatomía & histologíaRESUMEN
BACKGROUND AND OBJECTIVES: In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies. METHODS: One hundred fifty-three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion, and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined. RESULTS: A total of 25.4% of the patients had difficult intubations. SPIDS scores > 10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT. CONCLUSIONS: The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.
Asunto(s)
Intubación Intratraqueal/métodos , Cuello/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Intubación Intratraqueal/instrumentación , Laringectomía/estadística & datos numéricos , Avance Mandibular , Traumatismos Maxilofaciales/cirugía , Persona de Mediana Edad , Boca/fisiología , Neoplasias Nasofaríngeas , Cuello/anatomía & histología , Disección del Cuello/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud , Valor Predictivo de las Pruebas , Estudios Prospectivos , Curva ROC , Rango del Movimiento Articular , Sensibilidad y Especificidad , Glándula Tiroides/cirugía , Neoplasias de la Lengua/cirugía , Adulto JovenRESUMEN
Abstract Introduction Social media as YouTube have become a part of daily life and many studies evaluated health-related YouTube videos. Our aim was to evaluate videos available on YouTube for the conformity to textbook information and their sufficiency as a source for patient information. Material and method A search of the YouTube website was performed using the keywords "spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia". Firstly, 180 videos were evaluated and the characteristics of the video were noted, and the features of the video too were noted if the video was regarding neuraxial anesthesia. Questionnaire 1 (Q1) evaluating the video quality relating to neuraxial anesthesia was designed using a textbook as reference and questionnaire 2 (Q2) was designed for evaluating patient information. Results After exclusions, 40 videos were included in the study. There was no difference in Q1 or Q2 scores when videos were grouped into 4 quarters according to their appearance order, time since upload or views to length rate (p > 0.05). There was no statistical difference between Q1 or Q2 scores for spinal, epidural or combined videos (p > 0.05). Videos prepared by a healthcare institute have a higher score in both Questionnaires 1 and 2 (10.87 ± 4.28 vs. 5.84 ± 2.90, p = 0.044 and 3.89 ± 5.43 vs. 1.19 ± 3.35, p = 0.01 respectively). Conclusion Videos prepared by institutes, societies, etc. were of higher educational value, but were still very lacking. Videos should be prepared in adherence to available and up-to-date guidelines taking into consideration appropriate step by step explanation of each procedure, patient safety and frequently asked questions.
Resumo Introdução As mídias sociais como o YouTube tornaram-se uma parte do cotidiano e muitos estudos avaliaram vídeos do YouTube relacionados à saúde. Nosso objetivo foi avaliar os vídeos disponíveis no YouTube para identificar a existência de conformidade com as informações em livros didáticos e sua suficiência como fonte de informação para o paciente. Material e método Uma pesquisa no site YouTube foi feita com as palavras-chave spinal anesthesia, epidural anesthesia, combined spinal-epidural anesthesia (raquianestesia, anestesia peridural, anestesia combinada raquiperidural). Em primeiro lugar, avaliamos 180 vídeos e observamos suas características e se eram referentes à anestesia neuraxial. O questionário de avaliação da qualidade do vídeo (Q1) relativa à anestesia neuraxial foi criado com um livro didático como referência e o questionário 2 (Q2) foi criado para avaliar as informações ao paciente. Resultados Após exclusões, 40 vídeos foram incluídos no estudo. Não houve diferença nos escores de Q1 ou Q2 quando os vídeos foram agrupados em quatro categorias de acordo com a ordem de aparecimento, tempo de upload ou taxa de tempo de visualização (p > 0,05). Não houve diferença estatística entre os escores de Q1 ou Q2 para os vídeos raquianestesia, peridural ou combinada (p > 0,05). Os vídeos preparados por um instituto de saúde obtiveram escores mais elevados em ambos Q1 e Q2 (10,87 ± 4,28 vs. 5,84 ± 2,90, p = 0,044 e 3,89 ± 5,43 vs. 1,19 ± 3,35, p = 0,01, respectivamente). Conclusão Os vídeos elaborados por institutos, sociedades etc. apresentaram um valor educativo maior, mas ainda muito incompleto. Os vídeos devem ser preparados em conformidade com as diretrizes atualizadas e disponíveis, com explicações adequadas e detalhadas sobre cada procedimento, segurança do paciente e perguntas mais frequentes.
Asunto(s)
Educación del Paciente como Asunto , Medios de Comunicación Sociales/normas , Anestesia Epidural , Anestesia RaquideaRESUMEN
INTRODUCTION: Social media as YouTube have become a part of daily life and many studies evaluated health-related YouTube videos. Our aim was to evaluate videos available on YouTube for the conformity to textbook information and their sufficiency as a source for patient information. MATERIAL AND METHOD: A search of the YouTube website was performed using the keywords "spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia". Firstly, 180 videos were evaluated and the characteristics of the video were noted, and the features of the video too were noted if the video was regarding neuraxial anesthesia. Questionnaire 1 (Q1) evaluating the video quality relating to neuraxial anesthesia was designed using a textbook as reference and questionnaire 2 (Q2) was designed for evaluating patient information. RESULTS: After exclusions, 40 videos were included in the study. There was no difference in Q1 or Q2 scores when videos were grouped into 4 quarters according to their appearance order, time since upload or views to length rate (p>0.05). There was no statistical difference between Q1 or Q2 scores for spinal, epidural or combined videos (p>0.05). Videos prepared by a healthcare institute have a higher score in both Questionnaires 1 and 2 (10.87±4.28 vs. 5.84±2.90, p=0.044 and 3.89±5.43 vs. 1.19±3.35, p=0.01 respectively). CONCLUSION: Videos prepared by institutes, societies, etc. were of higher educational value, but were still very lacking. Videos should be prepared in adherence to available and up-to-date guidelines taking into consideration appropriate step by step explanation of each procedure, patient safety and frequently asked questions.