Difficult airway management in 25 hospitals across China: A multicenter cross-sectional study
Authors' conclusion
The accuracy of difficult airway assessment and first attempt intubation success is influenced by both patient-related factors and the anesthesiologist's expertise.
Study context
- Population
- GA patients with difficult airways in 25 secondary and tertiary hospitals across China, November 2022 to November 2023384 (0.21 %) difficult airways
- Participants
- 181,399 patients
- Exposure
- Anticipated difficult airways vs Unanticipated difficult airways
- Outcome
- Induction/intubation technique used
Methodological detailsmulticentre, observational, Data from a specialized questionnaire (four sections, 27 questions), analysed by logistic regression
- Multicentre
- Observational
- Data from a specialized questionnaire (four sections, 27 questions), analysed by logistic regression
Main finding
As reported in the abstract
| Group | Value | RSI | Spontaneous breathing under GA | Awake intubation | RSI (anesthesiologists opting) |
|---|---|---|---|---|---|
| Anticipated difficult airways | 51.7 % | 51.7 % | 11.1 % | 36 % | |
| Unanticipated difficult airways | 95.9 % | 95.9 % |
Value
Anticipated difficult airways51.7 %
Unanticipated difficult airways95.9 %
RSI
Anticipated difficult airways51.7 %
Unanticipated difficult airways— not stated in the abstract
Spontaneous breathing under GA
Anticipated difficult airways11.1 %
Unanticipated difficult airways— not stated in the abstract
Awake intubation
Anticipated difficult airways36 %
Unanticipated difficult airways— not stated in the abstract
RSI (anesthesiologists opting)
Anticipated difficult airways— not stated in the abstract
Unanticipated difficult airways95.9 %
Observational data: associations, not effects.
Further findings
Causes of difficult airways
- Limited mouth opening most common cause; obesity and ankylosing spondylitis significant factors
Factors influencing first attempt intubation success (logistic regression)
- Type of difficult airway, anesthesiologist experience and assessment methods identified as key factors
Original publication
Difficult airway management in 25 hospitals across China: A multicenter cross-sectional study. J Clin Anesth. Published 29 January 2025. doi:10.
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