Ellen de Kort

95 Evaluation of an Intubation Readiness Score 6 Outcome measures The primary outcome of this study was the positive predictive value of IRS 3 and 4 in predicting good quality of intubation. The quality of the intubation was assessed with the standardized intubation score of Viby-Mogensen et al. 22 Scoring included rating of laryngoscopy, vocal cords, coughing, jaw relaxation, and limb movements. Each itemwas assigned a score of 1 to 4 (Table 2). Good quality of intubationwas defined as a score ≤2 on each item. A score on one or more items of ≥3 implied inacceptable quality of intubation. Table 2. Viby-Mogensen intubation score Score Laryngoscopy Vocal cords Coughing Jaw relaxation Limb movements 1 Easy Open None Complete None 2 Fair Moving Slight Slight Slight 3 Difficult Closing Moderate Stiff Moderate 4 Impossible Closed Severe Rigid Severe Adequate intubation conditions were defined as a score ≤2 on each item Data collection Background characteristics as well as all IRS scores, data about all propofol doses, intubation conditions, and intubation attempts were collected on standardized intubation registration forms. Statistical analysis SPSS (IBM SPSS Statistics for Windows, version 22.0. Armonk, NY, USA) was used to analyze the data. Relevant patient data were reported as numbers with percentages for nominal variables and median and interquartile ranges (IQR) for continuous variables. Positive predictive values of IRS scores 3 and 4 combined as well as scores 3 and 4 separately, in predicting good quality of intubation, were determined (criterion validity). Univariate analysis was performed with Fisher’s exact tests for categorical variables and the Mann-Whitney test for continuous variables. Two-tailed p <0.05 was considered statistically significant. Ethical approval The IRS and Viby-Mogensen intubation score were implemented into daily practice as standard of care in both units because they potentially improved patient care. The study was judged as a prospective observational cohort study that did not incorporate extra risks or burden for the patients. Formal ethical approval to conduct the observational trial, according to the Dutch Law of Research with Humans, was not required (Medical Ethics Committee, Erasmus Medical Center, Rotterdam, the Netherlands, No. MEC-2017-240).