Lunstrom et al reported the DIFFMASK score for predicting difficult facemask ventilation for a patient. This can help to identify a patient who may require more aggressive airway management. The authors are from Nordsjaellands Hospital and Copenhagen University Hospital in Denmark.
Patient selection: facemask ventilation, >= 15 years of age
Parameters:
(1) age in years
(2) sex
(3) body mass index (BMI) in kg per square meter
(4) previous difficult tracheal intubation
(5) thyromental distance in cm
(6) modified Mallampati score
(7) full beard
(8) snoring
(9) sleep apnea
(10) neck radiation changes
Parameter
Finding
Points
age in years
15 to 44 years
0
45 to 59 years
2
60 to 80 years
3
> 80 years
3
sex
female
0
male
1
BMI
< 25
0
25 to 35
2
> 35
3
previous difficult tracheal intubation
no
0
possible
1
yes
1
thyromental distance
< 6.0 cm
2
6.0 to 6.5 cm
1
> 6.5 cm
0
modified Mallampati score
1 or 2
0
3
1
4
2
full beard
no
0
yes
2
snoring
no
0
yes
1
sleep apnea
no
0
yes
1
neck radiation changes
no
0
yes
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• A score >= 5 has a sensitivity of 85% and specificity of 59%.
Performance:
• The area under the ROC curve is 0.82.
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