Extended vs. Standard Mallampati Scoring for Morbidly Obese Patients

Extending the neck during Mallampati assessment increases specificity without loss of sensitivity for predicting difficult intubation.

Both the four-point modified Mallampati Score (MMP; assessed with the neck in neutral position) and the extended Mallampati Score (EMS; assessed with the neck in extension) have been used to predict difficult intubation in morbidly obese patients, but the two scores have not been directly compared. In a study of 5173 patients who had both scores evaluated before intubation during elective anesthesia, researchers compared the predictive value of MMP and EMS in the 346 morbidly obese patients (mean body mass index, 46; mean age, 50).

Among all obese patients, EMS scores were significantly lower than MMP scores. The EMS was lower than the MMP in 41 patients, higher in 4 patients, and the same in 301 patients. The authors considered EMS and MMP …

Reviewing Author

Ron M. Walls, MD, FRCPC, FAAEM

Disclosures

Speaker's bureauAirway Management Education Center, LLC

EquityAirway Management Education Center, LLC

Grant / Research supportAgency for Health Care Research and Quality

Editorial boardsManual of Emergency Airway Management; Rosen's Emergency Medicine; UpToDate; Scientific American Medicine

Leadership positions in professional societiesAssociation of Academic Chairs in Emergency Medicine (President)

Ron M. Walls, MD, FRCPC, FAAEM

Disclosures

Speaker's bureauAirway Management Education Center, LLC

EquityAirway Management Education Center, LLC

Grant / Research supportAgency for Health Care Research and Quality

Editorial boardsManual of Emergency Airway Management; Rosen's Emergency Medicine; UpToDate; Scientific American Medicine

Leadership positions in professional societiesAssociation of Academic Chairs in Emergency Medicine (President)