Prevalence and risk factors of difficult mask ventilation: A systematic review and meta-analysis
Authors' conclusion
Our results demonstrated the strengths of 13 most common risk factors for predicting difficult MV, which may serve as an evidence-based reference for clinicians to incorporate into their daily practice.
Study context
- Population
- Adults receiving anesthetic induction requiring mask ventilation, operating room
- Participants
- 335,846 adults · 20 observational studies
- Outcome
- Commonly reported risk factors for difficult mask ventilation and comparison of their predictive strengths
Methodological detailsEMBASE, MEDLINE, Google Scholar and Cochrane Library searched from inception to July 2022
- EMBASE, MEDLINE, Google Scholar and Cochrane Library searched from inception to July 2022
Pooled result
As reported in the abstract
Risk factors for difficult mask ventilation (all p < 0.05)
- Neck radiation, OR (5 studies, n = 277,843)
- 5.0
- Increased neck circumference, OR (11 studies, n = 247,871)
- 4.04
- Obstructive sleep apnea (OSA), OR (12 studies, n = 331,255)
- 3.61
- Presence of beard, OR (12 studies, n = 295,443)
- 3.35
- Snoring, OR (14 studies, n = 296,105)
- 3.06
- Obesity, OR (11 studies, n = 278,297)
- 2.99
- Male gender, OR (16 studies, n = 320,512)
- 2.76
- Mallampati score III-IV, OR (17 studies, n = 335,016)
- 2.36
- Limited mouth opening, OR (6 studies, n = 291,795)
- 2.18
- Edentulous, OR (11 studies, n = 249,821)
- 2.12
- Short thyroid-mental distance, OR (6 studies, n = 328,311)
- 2.12
- Old age, OR (11 studies, n = 278,750)
- 2
- Limited neck movement, OR (9 studies, n = 155,101)
- 1.98
Further pooled results
Prevalence of difficult mask ventilation, general population
- Prevalence (16 studies, n = 334,694)
- 6.1%
Prevalence of difficult mask ventilation, obesity
- Prevalence (4 studies, n = 1152)
- 14.4%
Original publication
Prevalence and risk factors of difficult mask ventilation: A systematic review and meta-analysis. J Clin Anesth. Published 4 July 2023. doi:10.
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