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A Retrospective Review of Difficult Intubations: Is Obstructive Sleep Apnea a Predictor?

Vest, David DMPNA, CRNA; Lee, Doohee PhD, MPH; Newcome, Kathy DMP, CRNA; Stamper, Heather CRNA

doi: 10.1097/NUR.0b013e31828c8346
Feature Article

Objective: The purpose of this study was to examine the association of obstructive sleep apnea (OSA) with difficult intubation in patients undergoing general anesthesia requiring tracheal intubation.

Methods: Using a retrospective, case-control study design, 90 adults with difficult tracheal intubation were compared with 81 gender-matched controls, between 2007 and 2010. Analyses included descriptive and inferential statistics, and multivariate regression was used to estimate predictors of difficult intubation while adjusting for patient demographics.

Results: In the univariate analysis, OSA was not associated with difficult intubation. After patient factors were controlled for in the multivariate logistic regression, patients without OSA were more likely to have difficult intubation (odds ratio, 0.36; 95% confidence interval, 0.13–0.99; P = .048). Other predictors of difficult intubation were lower body mass index and higher Mallampati score.

Discussion: In adult subjects, OSA history was not a predictor of difficult intubation. Other patient or anesthesiologist factors should be assessed for their association with difficult intubation.

Author Affiliations: Staff Anesthetist (Dr Vest), Professional Anesthesia Services, Charleston, West Virginia; Associate Professor (Dr Lee), Department of Management, Marketing, MIS, Marshall University, Charleston, West Virginia; Instructor (Dr Newcome), and Staff Anesthetist (Ms Stamper), Charleston Area Medical Center, West Virginia.

The authors report no conflicts of interest.

Correspondence: Doohee Lee, PhD, MPH, Marshall University, Charleston, WV 25303 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins