EGRI v.1
El-Ganzouri Risk Index (EGRI) is used in patients undergoing general anesthesia to predict the difficult airway for endotracheal intubation. The preoperative prediction of difficult airway for intubation can reduce the incidence of catastrophic complications or unnecessary maneuvers.
The purpose is to determine the El-Ganzouri Risk Index (EGRI) and stratify the risk for difficult airway.
EGRI is a simple scoring system that helps in making preoperative stratification of patients into risk groups for the difficulty in visualizing laryngeal structures during rigid laryngoscopy after induction of general anesthesia. predicts the risk level for difficult airway in a patient undergoing anesthesia. It is the sum of points of all the 7 variables and ranges from 0 to 12. Variable Points Mouth opening ≥4 cm 0 <4 cm 1 Thyromental distance* >6.5 cm 0 6.0-6.5 cm 1 <6.0 cm 2 Modified Mallampati Classification I (soft palate, fauces, uvula, and pillars seen) 0 II (soft palate, fauces, and uvula seen) 1 III (soft palate and base of uvula seen) 2 IV (soft palate not visible) 2 Neck movement ** >90° 0 80-90° 1 <80° 2 Ability to prognath*** Yes 0 No 1 Weight <90 kg (198.4 lbs) 0 90-110 kg (198.4-242.5 lbs) 1 >110 kg (242.5 lbs) 2 History of difficult intubation None 0 Questionable 1 Definite 2 * Thyromental distance was measured along a straight line from the thyroid notch to the lower border of the mandibular mentum with the head fully extended. ** Head and neck movement was measured as described by asking the patient to fully extend the head and neck ( Wilson et al). The range of motion from full extension through full flexion was categorized ***Ability to advance the lower jaw forward Interpretation of EGRI EGRI >=4 - High Risk for difficult airway EGRI < 4 - Low risk for difficult airway
Clinicians must understand the limitations of the predictive model and be prepared to take appropriate actions when unanticipated difficulty arises.
1. El-Ganzouri AR, McCarthy RJ, Tuman KJ, Tanck EN, Ivankovich AD. Preoperative airway assessment: predictive value of a multivariate risk index. Anesth Analg. 1996 Jun;82(6):1197–204. 2. Cortellazzi P, Minati L, Falcone C, Lamperti M, Caldiroli D. Predictive value of the El-Ganzouri multivariate risk index for difficult tracheal intubation: a comparison of Glidescope® videolaryngoscopy and conventional Macintosh laryngoscopy. Br J Anaesth. 2007 Dec 1;99(6):906–11. 3. Corso RM, Cattano D, Buccioli M, Carretta E, Maitan S. Post analysis simulated correlation of the El-Ganzouri airway difficulty score with difficult airway. Brazilian Journal of Anesthesiology (English Edition). 2016 May 1;66(3):298–303.
OBSERVATION.el_ganzouri_risk_index.v0, OBSERVATION.body_weight.v2, EVALUATION.el_ganzouri_risk_index_assessment.v0
