Anesth Analg 2006;102:1867-1878
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000217211.12232.55
GENERAL ARTICLES
A Systematic Review (Meta-Analysis) of the Accuracy of the Mallampati Tests to Predict the Difficult Airway
Anna Lee, PhD, MPH,
Lawrence T. Y. Fan, MBBS, FANZCA,
Tony Gin, MD, FRCA, FANZCA, MB, ChB,
Manoj K. Karmakar, MD, FRCA, and
Warwick D. Ngan Kee, MD, FANZCA, MB, ChB
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
Address correspondence to Anna Lee, PhD, MPH, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong. Address e-mail to annalee{at}cuhk.edu.hk.
The original and modified Mallampati tests are commonly used to predict the difficult airway, but there is controversy regarding their accuracy. We searched MEDLINE and other databases for prospective studies of patients undergoing general anesthesia in which the results of a preoperative Mallampati test were compared with the subsequent rate of difficult airway (difficult laryngoscopy, difficult intubation, or difficult ventilation as reference tests). Forty-two studies enrolling 34,513 patients were included. The definitions of the reference tests varied widely. For predicting difficult laryngoscopy, both versions of the Mallampati test had good accuracy (area under the summary receiver operating characteristic (sROC) curve = 0.89 ± 0.05 and 0.78 ± 0.05, respectively). For predicting difficult intubation, the modified Mallampati test had good accuracy (area under the sROC curve = 0.83 ± 0.03) whereas the original Mallampati test was poor (area under the sROC curve = 0.58 ± 0.12). The Mallampati tests were poor at identifying difficult mask ventilation. Publication bias was not detected. Used alone, the Mallampati tests have limited accuracy for predicting the difficult airway and thus are not useful screening tests.
This article has been cited by other articles:

|
 |

|
 |
 
L. H. Lundstrom, A. M. Moller, C. Rosenstock, G. Astrup, M. R. Gatke, J. Wetterslev, and the Danish Anaesthesia Database
Avoidance of neuromuscular blocking agents may increase the risk of difficult tracheal intubation: a cohort study of 103 812 consecutive adult patients recorded in the Danish Anaesthesia Database
Br. J. Anaesth.,
August 1, 2009;
103(2):
283 - 290.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. Jungbauer, M. Schumann, V. Brunkhorst, A. Borgers, and H. Groeben
Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients
Br. J. Anaesth.,
April 1, 2009;
102(4):
546 - 550.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K.-y. Rhee, J.-r. Lee, J. Kim, S. Park, W.-K. Kwon, and S. Han
A Comparison of Lighted Stylet (Surch-LiteTM) and Direct Laryngoscopic Intubation in Patients with High Mallampati Scores
Anesth. Analg.,
April 1, 2009;
108(4):
1215 - 1219.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Huh, H.-Y. Shin, S.-H. Kim, T.-K. Yoon, and D.-K. Kim
Diagnostic Predictor of Difficult Laryngoscopy: The Hyomental Distance Ratio
Anesth. Analg.,
February 1, 2009;
108(2):
544 - 548.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Mallampati Score Predicts Difficult Laryngoscopy and Intubation
Journal Watch Emergency Medicine,
July 28, 2006;
2006(728):
2 - 2.
[Full Text]
|
 |
|
|