Pediatric anesthesia & critical care
Prospective development and validation of a universal classification for paediatric videolaryngoscopic tracheal intubation: the PeDiAC score
Authors' conclusion
We developed and validated a specifically tailored classification for paediatric videolaryngoscopic tracheal intubation with excellent diagnostic performance and calibration that outperformed the Cormack and Lehane classification.
Study context
- Population
- Children undergoing tracheal intubation with C-MAC videolaryngoscopes for elective surgical procedures
- Participants
- 809 children · 904 intubation episodes
- Exposure
- PeDiAC score vs Cormack and Lehane classification
- Outcome
- Diagnostic performance (AUC) of the PeDiAC score for classifying difficult videolaryngoscopic tracheal intubation vs Cormack and Lehane
Methodological detailsdiagnostic model development and validation, multivariable logistic regression, external validation of VIDIAC score, Conducted within a structured universal videolaryngoscopy implementation programme, Eight factors selected by 100-times repeated 10-fold cross-validated LASSO regression
- Diagnostic model development and validation
- Multivariable logistic regression
- External validation of VIDIAC score
- Conducted within a structured universal videolaryngoscopy implementation programme
- Eight factors selected by 100-times repeated 10-fold cross-validated LASSO regression
Main finding
As reported in the abstract
AUC for difficult videolaryngoscopic intubation
| Group | AUC |
|---|---|
| PeDiAC score | 0.97 (95%CI 0.96-0.99) |
| Cormack and Lehane | 0.69 (95%CI 0.62-0.76) |
AUC
PeDiAC score0.97 (95%CI 0.96-0.99)
Cormack and Lehane0.69 (95%CI 0.62-0.76)
- PeDiAC score vs Cormack and Lehane: P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | VIDIAC score | Cormack and Lehane | P value |
|---|---|---|---|
| External validation of VIDIAC score: AUCVIDIAC score vs Cormack and Lehane | P = 0.018 | ||
| AUC | 0.80 (95%CI 0.73-0.87) | 0.69 (95%CI 0.62-0.76) |
Original publication
Prospective development and validation of a universal classification for paediatric videolaryngoscopic tracheal intubation: the PeDiAC score. Anaesthesia. Published 7 August 2024. doi:10.
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