Increased Rate of Poor Laryngoscopic Views in Patients Scheduled for Cardiac Surgery Versus Patients Scheduled for General Surgery A Propensity Score-Based Analysis of 21,561 Cases.pdfVIP

Increased Rate of Poor Laryngoscopic Views in Patients Scheduled for Cardiac Surgery Versus Patients Scheduled for General Surgery: A Propensity Score-Based Analysis of 21,561 Cases Sebastian Heinrich, MD, Andreas Ackermann, DSc, Johannes Prottengeier, MD, Ixchel Castellanos, MD, Joachim Schmidt, and Jürgen Schüttler Objectives: Former analyses reported an increased rate of poor direct laryngoscopy view in cardiac surgery patients; however, these ?ndings frequently could be attributed to confounding patient characteristics. In most of the reported cardiac surgery cohorts, the rate of well-known risk factors for poor direct laryngoscopy view such as male sex, obesity, or older age, were increased compared with the control groups. Especially in the ongoing debate on anesthesia staff quali?cation for cardiac interventions outside the operating room a detailed and strati?ed risk analysis seems necessary. Design: Retrospective, anonymous, propensity scorebased, matched-pair analysis. Setting: Single-center study in a university hospital. Participants: No active participants. Retrospective, anonymous chart analysis. Interventions: The anesthesia records of patients undergoing cardiac surgery in a period of 6 consecutive years were analyzed retrospectively. The results were compared with those of a control group of patients who underwent general surgery. Poor laryngoscopic view was de?ned as Cormack and Lehane classi?cation grade 3 or 4. Measurements and Main Results: The records of 21,561 general anesthesia procedures were reviewed for the study. The incidence of poor direct laryngoscopic views in patients scheduled for cardiac surgery was signi?cantly increased compared with those of the general surgery cohort (7% v 4.2%). Using propensity scorebased matched-pair analysis, equal subgroups were generated of each surgical department, with 2,946 patients showing identical demographic characteristics. After stratifying for demographic characteristics, the rate of poor direct