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. 2023 Dec 19;12(1):e17.
doi: 10.22037/aaem.v12i1.2178. eCollection 2024.

MONTH Score in Predicting Difficult Intubations in Emergency Department; a Prognostic Accuracy Study

Nitis Hongthong  1 , Sorravit Savatmongkorngul  1 , Chaiyaporn Yuksen  1 , Thanakorn Laksanamapune  1
Affiliations

MONTH Score in Predicting Difficult Intubations in Emergency Department; a Prognostic Accuracy Study

Nitis Hongthong et al. Arch Acad Emerg Med. .

Abstract

Introduction: MONTH Difficult Laryngoscopy Score was developed for effectively identifying difficult intubations in the emergency department (ED). This study aimed to evaluate the accuracy of MONTH Score in predicting difficult intubations in ED.

Methods: We prospectively collected data on all patients undergoing intubation in the ED of Ramathibodi Hospital, Bangkok, Thailand. The screening performance characteristics of the MONTH score in identifying the difficult intubation in ED were analyzed. All data were analyzed using STATA software version 18.0.

Results: 324 intubated patients with the median age of 73 (63-82) years were studied (63.58% male). The proportion of difficult intubations was 19.44%. The sensitivity and specificity of MONTH in predicting difficult intubations were 74.6% (95% CI: 61.6%-85.0%) and 92.8% (95% CI: 89.0%-95.6%), respectively. These measures in subgroup of patients with Intubation Difficulty Scale (IDS) score ≥ 6 were 44.1% (95%CI: 31.2-57.6) and 98.5% (95% CI: 96.2%- 99.6%), respectively. The area under the receiver operation characteristic (ROC) curve of MONTH in predicting difficult intubations was 0.895 (95% CI: 0.856- 0.926).

Conclusions: It seems that the MONTH Difficult Laryngoscopy Score could be considered as a tool with high specificity and positive predictive values in identifying cases with difficult intubations in ED.

Keywords: Clinical decision rules; Emergency service; Intubation; Laryngoscopy; Validation study; hospital.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flowchart of patient inclusion in this study
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References

    1. Orebaugh SL. Difficult airway management in the emergency department. J Emerg Med. 2002;22(1):31–48. - PubMed
    1. Soyuncu S, Eken C, Cete Y, Bektas F, Akcimen M. Determination of difficult intubation in the ED. Am J Emerg Med. 2009;27(8):905–10. - PubMed
    1. Seo SH, Lee JG, Yu SB, Kim DS, Ryu SJ, Kim KH. Predictors of difficult intubation defined by the intubation difficulty scale (IDS): predictive value of 7 airway assessment factors. Korean J Anesthesiol. 2012;63(6):491–7. - PMC - PubMed
    1. Sagarin MJ, Barton ED, Chng YM, Walls RM. Airway management by US and Canadian emergency medicine residents: a multicenter analysis of more than 6,000 endotracheal intubation attempts. Ann Emerg Med. 2005;46(4):328–36. - PubMed
    1. Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011;114(1):42–8. - PubMed

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