Difficult Tracheal Intubation is More Common among Hazara Tribe and Females in Afghanistan

Introduction: Airway management is a considerable challenge for anesthesiologists. The diagnostic value of the screening tests differs in various studies. This is due to the variety in the incidence of intubation, insufficient statistical power, and different test inception. To have a safe intubation, it is essential to perform a precise preoperative airway assessment. However, there is still an argument about which tests and anatomical landmarks would be the best predictors.Objective: This study is aimed to determine the best predictors and socio-demographic characteristics of difficult intubation among adult patients scheduled for elective surgeries under general anesthesia in Aliabad Teaching Hospital, Kabul, Afghanistan. Method: A total of 341 patients were selected based on consecutive sampling method. Informed consent forms were obtained before inclusion in the study. Data were collected using a data collection form. Age, gender, ASA physical status and tribe were recorded for each participant. Airway assessment test was conducted before operation for additional consideration. Data were initially entered into an excel data sheet, and then exported to SPSS Statistics version 22 for analysis. Results: From a total of 341 patients, 193 (56.6%) were males and 148 (43.4%) were females. The mean age of the subjects was 36.98 ± 15.048 years. More than half (54.5%) of the study population were Tajiks. Hazara tribe, female patients, increasing age and systemic disease patients had more difficult intubation. We recognized that, Mallampati classes, mouth opening, thyromental distance, ability to prognath and neck mobility and size were associated with difficult intubation. Multiple logistic regression analysis of the associated factors determined that increase age, ability to prognath and mouth opening were independent predictors of difficult intubation. Conclusion: Female patients and Hazara tribe were found to have a significant association with difficult intubation on bivariate analysis. Multiple logistic regression analysis determined that increase age, ability to prognath and mouth opening were independent predictors for difficult intubation.