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The Mallampati score, an assessment of tongue size relative to the oral pharynx, has become a staple among the difficult-intubation assessment tools. To determine its accuracy, these investigators performed a systematic review and meta-analysis of prospective studies that compared preoperative Mallampati scores with subsequent rates of difficult laryngoscopy, intubation, and bag-mask ventilation.
They identified 42 studies that enrolled 34,513 patients. Both the original (3-point scale) and modified (4-point scale) Mallampati scores were assessed.
Performance of the two scores did not differ significantly for predicting difficult laryngoscopy. The original score had a sensitivity of 0.71, a specificity of 0.89, and an area under the receiver-…