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Disease activity in rheumatoid arthritis as a predictor of difficult intubation?

Published online by Cambridge University Press:  01 October 2008

B. Cagla Ozbakis Akkurt ,
H. Guler ,
K. Inanoglu ,
A. Dicle Turhanoglu ,
S. Turhanoglu  and
Z. Asfuroglu
B. Cagla Ozbakis Akkurt*
Affiliation:
Mustafa Kemal University, School of Medicine, Department of Anaesthesiology, Hatay, Turkey
H. Guler
Affiliation:
Mustafa Kemal University, School of Medicine, Department of Physical Therapy, Hatay, Turkey
K. Inanoglu
Affiliation:
Mustafa Kemal University, School of Medicine, Department of Anaesthesiology, Hatay, Turkey
A. Dicle Turhanoglu
Affiliation:
Mustafa Kemal University, School of Medicine, Department of Physical Therapy, Hatay, Turkey
S. Turhanoglu
Affiliation:
Mustafa Kemal University, School of Medicine, Department of Anaesthesiology, Hatay, Turkey
Z. Asfuroglu
Affiliation:
Mustafa Kemal University, School of Medicine, Department of Anaesthesiology, Hatay, Turkey
*
Correspondence to: Bucket Cagla Ozbakis Akkurt, Department of Anaesthesiology, School of Medicine, Mustafa Kemal University, Bagriyanik Mahallesi, Hatay 31100, Turkey. E-mail: caglabuket@gmail.com; Tel: +90 505 3783204; Fax: +90 326 2148214
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Summary

Background and objectives

Rheumatoid arthritis is a lifelong systemic disease that can affect any joint with a synovium. Managing intubation in patients with rheumatoid disease is a special challenge in these patients especially if specific joints, which play an important role during intubation, are affected. We aimed to investigate if there was a correlation between the activity and duration of the disease and the commonly used predictors of difficult intubation in rheumatoid arthritis.

Methods

Sixty-six patients with the diagnosis of rheumatoid arthritis and 60 control patients were included in the study. Patient characteristics were recorded. Body mass index, disease activity scores, Mallampati classification, sternomental distance, thyromental distance, inter-incisor distance and atlanto-occipital joint extension were measured for each patient. Every patient was asked to complete the Stanford Health Assessment Questionnaire (HAQ score). Disease activity score (DAS 28 score) including 28 joints was used to assess the activity of the disease. Correlation between the predictors of difficult intubation and activity was assessed and was compared with the control group.

Results

Mallampati scores were higher (P = 0.000), sternomental distance (P = 0.005) and inter-incisor distance (P = 0.003) were shorter and also occlusal surface–upper teeth angle (P = 0.000) and mouth corner–tragus line angle were smaller in the rheumatoid arthritis group compared with controls (P = 0.000). We did not observe a correlation between the disease activity scores and the Mallampati score (P = 0.619), sternomental distance (P = 0.195), thyromental distance (P = 0.174), inter-incisor distance (P = 0.764), angle I (P = 0.372) and angle II (P = 0.609). There was no correlation between the HAQ score and the Mallampati score (P = 0.872), sternomental distance (P = 0.455), thyromental distance (P = 0.841), inter-incisor distance (P = 0.162), angle I (P = 0.768) and angle II (P = 0.287). There was no correlation between the duration of the disease and the Mallampati score (P = 0.619), sternomental distance (P = 0.505), thyromental distance (P = 0.426), inter-incisor distance (P = 0.813), angle I (P = 0.377) and angle II (P = 0.600).

Conclusion

Tests of disease activity and the duration of the disease were not found to be correlated with the predictors of difficult intubation in this study. Thus, performing the predictive tests for difficult intubation especially in patients with very low scores or short disease is recommended.

Keywords

INTUBATION INTRATRACHEALRHEUMATOID ARTHRITIS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 10 , October 2008 , pp. 800 - 804
Copyright
Copyright © European Society of Anaesthesiology 2008

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