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<record>
<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Clinical Experiences with the FRONT Formula for Pre-Operative Airway Assessment and Documentation: a Multi-Centre Study</title>
<author>
<name sortKey="Mitre, Calin" sort="Mitre, Calin" uniqKey="Mitre C" first="Calin" last="Mitre">Calin Mitre</name>
<affiliation>
<nlm:aff id="af1-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mitre, Ileana" sort="Mitre, Ileana" uniqKey="Mitre I" first="Ileana" last="Mitre">Ileana Mitre</name>
<affiliation>
<nlm:aff id="af2-tard-45-4-225">Department of Anesthesiology for Buco Maxillo-Facial Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Gyongyosi, Zoltan" sort="Gyongyosi, Zoltan" uniqKey="Gyongyosi Z" first="Zoltán" last="Gyöngyösi">Zoltán Gyöngyösi</name>
<affiliation>
<nlm:aff id="af3-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Fulesdi, Bela" sort="Fulesdi, Bela" uniqKey="Fulesdi B" first="Béla" last="Fülesdi">Béla Fülesdi</name>
<affiliation>
<nlm:aff id="af3-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zdrehus, Claudiu" sort="Zdrehus, Claudiu" uniqKey="Zdrehus C" first="Claudiu" last="Zdrehus">Claudiu Zdrehus</name>
<affiliation>
<nlm:aff id="af1-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Breazu, Caius" sort="Breazu, Caius" uniqKey="Breazu C" first="Caius" last="Breazu">Caius Breazu</name>
<affiliation>
<nlm:aff id="af1-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Biro, Peter" sort="Biro, Peter" uniqKey="Biro P" first="Peter" last="Biro">Peter Biro</name>
<affiliation>
<nlm:aff id="af4-tard-45-4-225">Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland</nlm:aff>
</affiliation>
</author>
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<idno type="pmid">28868170</idno>
<idno type="pmc">5579216</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579216</idno>
<idno type="RBID">PMC:5579216</idno>
<idno type="doi">10.5152/TJAR.2017.97992</idno>
<date when="2017">2017</date>
<idno type="wicri:Area/Pmc/Corpus">002570</idno>
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<title xml:lang="en" level="a" type="main">Clinical Experiences with the FRONT Formula for Pre-Operative Airway Assessment and Documentation: a Multi-Centre Study</title>
<author>
<name sortKey="Mitre, Calin" sort="Mitre, Calin" uniqKey="Mitre C" first="Calin" last="Mitre">Calin Mitre</name>
<affiliation>
<nlm:aff id="af1-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mitre, Ileana" sort="Mitre, Ileana" uniqKey="Mitre I" first="Ileana" last="Mitre">Ileana Mitre</name>
<affiliation>
<nlm:aff id="af2-tard-45-4-225">Department of Anesthesiology for Buco Maxillo-Facial Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Gyongyosi, Zoltan" sort="Gyongyosi, Zoltan" uniqKey="Gyongyosi Z" first="Zoltán" last="Gyöngyösi">Zoltán Gyöngyösi</name>
<affiliation>
<nlm:aff id="af3-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Fulesdi, Bela" sort="Fulesdi, Bela" uniqKey="Fulesdi B" first="Béla" last="Fülesdi">Béla Fülesdi</name>
<affiliation>
<nlm:aff id="af3-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zdrehus, Claudiu" sort="Zdrehus, Claudiu" uniqKey="Zdrehus C" first="Claudiu" last="Zdrehus">Claudiu Zdrehus</name>
<affiliation>
<nlm:aff id="af1-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Breazu, Caius" sort="Breazu, Caius" uniqKey="Breazu C" first="Caius" last="Breazu">Caius Breazu</name>
<affiliation>
<nlm:aff id="af1-tard-45-4-225">Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Biro, Peter" sort="Biro, Peter" uniqKey="Biro P" first="Peter" last="Biro">Peter Biro</name>
<affiliation>
<nlm:aff id="af4-tard-45-4-225">Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Turkish Journal of Anaesthesiology and Reanimation</title>
<idno type="ISSN">2149-0937</idno>
<idno type="eISSN">2149-276X</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
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<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Objective</title>
<p>The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties.</p>
</sec>
<sec>
<title>Methods</title>
<p>This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management. An intra-operative team of evaluators (team B) working independently of team A, performed the actual instrumentation of the airway and scored the actual findings. Both teams used the FRONT scoring system and worked independently of each other to ensure blinded assessments. The statistical analysis of the pre- and intra-operative FRONT scores was performed in an off-line blinded manner.</p>
</sec>
<sec>
<title>Results</title>
<p>Our results show a fair and promising association between pre-operative composite FRONT score and that observed at the induction phase (Spearman=0.43). Among the score components, the best correlation was observed for the F and R components (kappa=0.44 and 0.36, respectively), and the worse correlation was observed for the O and T components (kappa=0.25 and 0.24, respectively).</p>
</sec>
<sec>
<title>Conclusion</title>
<p>The FRONT formula for the prediction and documentation of the airway status is a simple and effective method for assessing and defining airway management difficulties. Further prospective studies are required to assess the sensitivity and specificity of the system.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Turk J Anaesthesiol Reanim</journal-id>
<journal-id journal-id-type="iso-abbrev">Turk J Anaesthesiol Reanim</journal-id>
<journal-title-group>
<journal-title>Turkish Journal of Anaesthesiology and Reanimation</journal-title>
</journal-title-group>
<issn pub-type="ppub">2149-0937</issn>
<issn pub-type="epub">2149-276X</issn>
<publisher>
<publisher-name>Turkish Anaesthesiology and Intensive Care Society</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">28868170</article-id>
<article-id pub-id-type="pmc">5579216</article-id>
<article-id pub-id-type="doi">10.5152/TJAR.2017.97992</article-id>
<article-id pub-id-type="publisher-id">tard-45-4-225</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Clinical Experiences with the FRONT Formula for Pre-Operative Airway Assessment and Documentation: a Multi-Centre Study</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Mitre</surname>
<given-names>Calin</given-names>
</name>
<xref ref-type="aff" rid="af1-tard-45-4-225">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mitre</surname>
<given-names>Ileana</given-names>
</name>
<xref ref-type="aff" rid="af2-tard-45-4-225">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gyöngyösi</surname>
<given-names>Zoltán</given-names>
</name>
<xref ref-type="aff" rid="af3-tard-45-4-225">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Fülesdi</surname>
<given-names>Béla</given-names>
</name>
<xref ref-type="aff" rid="af3-tard-45-4-225">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zdrehus</surname>
<given-names>Claudiu</given-names>
</name>
<xref ref-type="aff" rid="af1-tard-45-4-225">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Breazu</surname>
<given-names>Caius</given-names>
</name>
<xref ref-type="aff" rid="af1-tard-45-4-225">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Biro</surname>
<given-names>Peter</given-names>
</name>
<xref ref-type="aff" rid="af4-tard-45-4-225">4</xref>
<xref ref-type="corresp" rid="c1-tard-45-4-225"></xref>
</contrib>
</contrib-group>
<aff id="af1-tard-45-4-225">
<label>1</label>
Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</aff>
<aff id="af2-tard-45-4-225">
<label>2</label>
Department of Anesthesiology for Buco Maxillo-Facial Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania</aff>
<aff id="af3-tard-45-4-225">
<label>3</label>
Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary</aff>
<aff id="af4-tard-45-4-225">
<label>4</label>
Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland</aff>
<author-notes>
<corresp id="c1-tard-45-4-225">Address for Correspondence: Peter Biro, E-mail:
<email>peter.biro@usz.ch</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>8</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>01</day>
<month>8</month>
<year>2017</year>
</pub-date>
<volume>45</volume>
<issue>4</issue>
<fpage>225</fpage>
<lpage>230</lpage>
<history>
<date date-type="received">
<day>10</day>
<month>2</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>13</day>
<month>7</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© Copyright 2017 by Turkish Anaesthesiology and Intensive Care Society</copyright-statement>
<copyright-year>2017</copyright-year>
</permissions>
<abstract>
<sec>
<title>Objective</title>
<p>The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties.</p>
</sec>
<sec>
<title>Methods</title>
<p>This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management. An intra-operative team of evaluators (team B) working independently of team A, performed the actual instrumentation of the airway and scored the actual findings. Both teams used the FRONT scoring system and worked independently of each other to ensure blinded assessments. The statistical analysis of the pre- and intra-operative FRONT scores was performed in an off-line blinded manner.</p>
</sec>
<sec>
<title>Results</title>
<p>Our results show a fair and promising association between pre-operative composite FRONT score and that observed at the induction phase (Spearman=0.43). Among the score components, the best correlation was observed for the F and R components (kappa=0.44 and 0.36, respectively), and the worse correlation was observed for the O and T components (kappa=0.25 and 0.24, respectively).</p>
</sec>
<sec>
<title>Conclusion</title>
<p>The FRONT formula for the prediction and documentation of the airway status is a simple and effective method for assessing and defining airway management difficulties. Further prospective studies are required to assess the sensitivity and specificity of the system.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Difficult airway</kwd>
<kwd>prediction of intubation</kwd>
<kwd>documentation of airway status</kwd>
<kwd>FRONT score</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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