Modified mallampati classification as a clinical predictor of peroral esophagogastroduodenoscopy tolerance

Hsin-Hung Huang, Meei-Shyuan Lee, Yu-Lueng Shih, Heng-Cheng Chu, Tien-Yu Huang, Tsai-Yuan Hsieh

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Unsedated esophagogastroduodenoscopy (EGD) is simpler and safer than sedated EGD; however, approximately 40% of patients cannot tolerate it. Early identification of patients likely to poorly tolerate unsedated EGD is valuable for improving compliance. The modified Mallampati classification (MMC) has been used to evaluate difficult tracheal intubation and laryngoscope insertion. We tried to assess the efficacy of MMC to predict the tolerance of EGD in unsedated patients.Methods: Two hundred patients who underwent an unsedated diagnostic EGD were recruited. They were stratified according to the view of the oropharynx as either MMC class I + II (good view) or class III + IV (poor view). EGD tolerance was assessed in three ways: gag reflex by endoscopist assessment, patient satisfaction by interview, and the degree of change in vital signs.Results: MMC was significantly correlated to gag reflex (P <0.001), patient satisfaction (P = 0.028), and a change of vital signs (P = 0.024). Patients in the poor view group had a 3.87-fold increased risk of gag reflex (P <0.001), a 1.78-fold increased risk of unsatisfaction (P = 0.067), and a 1.96-fold increased risk of a change in vital signs (P = 0.025) compared to those in the good view group.Conclusions: MMC appears to be a clinically useful predictor of EGD tolerance. Patients with poor view of oropharynx by MMC criteria may be candidates for sedated or transnasal EGD. © 2011 Huang et al; licensee BioMed Central Ltd.
Original languageEnglish
JournalBMC Gastroenterology
Volume11
DOIs
Publication statusPublished - 2011
Externally publishedYes

Fingerprint

Digestive System Endoscopy
Vital Signs
Reflex
Oropharynx
Patient Satisfaction
Laryngoscopes
Intubation
Compliance
Interviews

Keywords

  • adult
  • age distribution
  • aged
  • anxiety
  • article
  • body mass
  • clinical trial
  • controlled clinical trial
  • controlled study
  • esophagogastroduodenoscopy
  • female
  • gastroesophageal reflux
  • human
  • interview
  • major clinical study
  • male
  • mean arterial pressure
  • medical specialist
  • modified mallampati classification
  • non invasive measurement
  • oropharynx
  • oxygen saturation
  • patient education
  • patient satisfaction
  • peptic ulcer
  • peroral esophagogastroduodenoscopy tolerance
  • physical tolerance
  • prediction
  • pulse rate
  • reliability
  • sensitivity and specificity
  • sex difference
  • smoking
  • adolescent
  • blood pressure
  • digestive tract endoscopy
  • evaluation
  • gastrointestinal symptom
  • glottis
  • heart rate
  • histology
  • middle aged
  • palate
  • physiology
  • predictive value
  • retrospective study
  • soft palate
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • Endoscopy, Digestive System
  • Female
  • Gagging
  • Gastroesophageal Reflux
  • Glottis
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Palate, Soft
  • Patient Satisfaction
  • Peptic Ulcer
  • Predictive Value of Tests
  • Retrospective Studies
  • Uvula
  • Young Adult

Cite this

Modified mallampati classification as a clinical predictor of peroral esophagogastroduodenoscopy tolerance. / Huang, Hsin-Hung; Lee, Meei-Shyuan; Shih, Yu-Lueng; Chu, Heng-Cheng; Huang, Tien-Yu; Hsieh, Tsai-Yuan.

In: BMC Gastroenterology, Vol. 11, 2011.

Research output: Contribution to journalArticle

Huang, Hsin-Hung ; Lee, Meei-Shyuan ; Shih, Yu-Lueng ; Chu, Heng-Cheng ; Huang, Tien-Yu ; Hsieh, Tsai-Yuan. / Modified mallampati classification as a clinical predictor of peroral esophagogastroduodenoscopy tolerance. In: BMC Gastroenterology. 2011 ; Vol. 11.
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title = "Modified mallampati classification as a clinical predictor of peroral esophagogastroduodenoscopy tolerance",
abstract = "Background: Unsedated esophagogastroduodenoscopy (EGD) is simpler and safer than sedated EGD; however, approximately 40{\%} of patients cannot tolerate it. Early identification of patients likely to poorly tolerate unsedated EGD is valuable for improving compliance. The modified Mallampati classification (MMC) has been used to evaluate difficult tracheal intubation and laryngoscope insertion. We tried to assess the efficacy of MMC to predict the tolerance of EGD in unsedated patients.Methods: Two hundred patients who underwent an unsedated diagnostic EGD were recruited. They were stratified according to the view of the oropharynx as either MMC class I + II (good view) or class III + IV (poor view). EGD tolerance was assessed in three ways: gag reflex by endoscopist assessment, patient satisfaction by interview, and the degree of change in vital signs.Results: MMC was significantly correlated to gag reflex (P <0.001), patient satisfaction (P = 0.028), and a change of vital signs (P = 0.024). Patients in the poor view group had a 3.87-fold increased risk of gag reflex (P <0.001), a 1.78-fold increased risk of unsatisfaction (P = 0.067), and a 1.96-fold increased risk of a change in vital signs (P = 0.025) compared to those in the good view group.Conclusions: MMC appears to be a clinically useful predictor of EGD tolerance. Patients with poor view of oropharynx by MMC criteria may be candidates for sedated or transnasal EGD. {\circledC} 2011 Huang et al; licensee BioMed Central Ltd.",
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author = "Hsin-Hung Huang and Meei-Shyuan Lee and Yu-Lueng Shih and Heng-Cheng Chu and Tien-Yu Huang and Tsai-Yuan Hsieh",
note = "被引用次數:7 Export Date: 22 March 2016 CODEN: BGMAB 通訊地址: Hsieh, T.-Y.; Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterTaiwan; 電子郵件: tyh1216@ms46.hinet.net 參考文獻: Abraham, N., Barkun, A., Larocque, M., Fallone, C., Mayrand, S., Baffis, V., Cohen, A., Joseph, L., Predicting which patients can undergo upper endoscopy comfortably without conscious sedation (2002) Gastrointest Endosc, 56, pp. 180-189. , 10.1016/S0016-5107(02)70175-2, 12145594; Zaman, A., Hapke, R., Sahagun, G., Katon, R.M., Unsedated peroral endoscopy with a video ultrathin endoscope: patient acceptance, tolerance, and diagnostic accuracy (1998) Am J Gastroenterol, 93, pp. 1260-1263. , 10.1111/j.1572-0241.1998.00406.x, 9707048; Mulcahy, H.E., Kelly, P., Banks, M.R., Connor, P., Patchet, S.E., Farthing, M.J., Fairclough, P.D., Kumar, P.J., Factors associated with tolerance to, and discomfort with, unsedated diagnostic gastroscopy (2001) Scand J Gastroenterol, 36, pp. 1352-1357. , 10.1080/003655201317097245, 11761029; Waring, J.P., Baron, T.H., Hirota, W.K., Goldstein, J.L., Jacobson, B.C., Leighton, J.A., Mallery, J.S., Faigel, D.O., Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy (2003) Gastrointest Endosc, 58, pp. 317-322. , 10.1067/S0016-5107(03)00001-4, 14528201; Levy, N., Abinader, E., Continuous electrocardiographic monitoring with Holter electrocardiocorder throughout all stages of gastroscopy (1977) Am J Dig Dis, 22, pp. 1091-1096. , 10.1007/BF01072863, 930908; Quine, M.A., Bell, G.D., McCloy, R.F., Charlton, J.E., Devlin, H.B., Hopkins, A., Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing, and sedation methods (1995) Gut, 36, pp. 462-467. , 10.1136/gut.36.3.462, 1382467, 7698711; Fisher, N.C., Bailey, S., Gibson, J.A., A prospective, randomized controlled trial of sedation vs. no sedation in outpatient diagnostic upper gastrointestinal endoscopy (1998) Endoscopy, 30, pp. 21-24. , 10.1055/s-2007-993723, 9548039; Froehlich, F., Schwizer, W., Thorens, J., Kohler, M., Gonvers, J.J., Fried, M., Conscious sedation for gastroscopy: patient tolerance and cardiorespiratory parameters (1995) Gastroenterology, 108, pp. 697-704. , 10.1016/0016-5085(95)90441-7, 7875472; Lazzaroni, M., Bianchi, P.G., Preparation, premedication, and surveillance (2005) Endoscopy, 37, pp. 101-109. , 10.1055/s-2004-826149, 15692924; Mallampati, S.R., Gatt, S.P., Gugino, L.D., Desai, S.P., Waraksa, B., Freiberger, D., Liu, P.L., A clinical sign to predict difficult tracheal intubation: a prospective study (1985) Can Anaesth Soc J, 32, pp. 429-434. , 10.1007/BF03011357, 4027773; Samsoon, G.L., Young, J.R., Difficult tracheal intubation: a retrospective study (1987) Anaesthesia, 42, pp. 487-490. , 10.1111/j.1365-2044.1987.tb04039.x, 3592174; Tan, C.C., Freeman, J.G., Throat spray for upper gastrointestinal endoscopy is quite acceptable to patients (1996) Endoscopy, 28, pp. 277-282. , 10.1055/s-2007-1005453, 8781790; Mahajan, R.J., Johnson, J.C., Marshall, J.B., Predictors of patient cooperation during gastrointestinal endoscopy (1997) J Clin Gastroenterol, 24, pp. 220-223. , 10.1097/00004836-199706000-00007, 9252844; Farhadi, A., Fields, J.Z., Hoseini, S.H., The assessment of esophagogastroduodenoscopy tolerance a prospective study of 300 cases (2001) Diagn Ther Endosc, 7, pp. 141-147. , 10.1155/DTE.7.141, 2362842, 18493558; Campo, R., Brullet, E., Montserrat, A., Calvet, X., Moix, J., Rue, M., Roque, M., Bordas, J.M., Identification of factors that influence tolerance of upper gastrointestinal endoscopy (1999) Eur J Gastroenterol Hepatol, 11, pp. 201-204. , 10.1097/00042737-199902000-00023, 10102233; Dumortier, J., Napoleon, B., Hedelius, F., Pellissier, P.E., Leprince, E., Pujol, B., Ponchon, T., Unsedated transnasal EGD in daily practice: results with 1100 consecutive patients (2003) Gastrointest Endosc, 57, pp. 198-204. , 10.1067/mge.2003.59, 12556784; Gelly, A.L., Farley, A., Boyer, J., Asselin, M., Spenard, J., Influence of sex, age and smoking status on patient comfort during gastroscopy with pharyngeal anesthesia by a new benzocaine-tetracaine preparation (1998) Can J Gastroenterol, 12, pp. 431-433; Soma, Y., Saito, H., Kishibe, T., Takahashi, T., Tanaka, H., Munakata, A., Evaluation of topical pharyngeal anesthesia for upper endoscopy including factors associated with patient tolerance (2001) Gastrointest Endosc, 53, pp. 14-18. , 10.1067/mge.2001.111773, 11154482; Faulx, A.L., Catanzaro, A., Zyzanski, S., Cooper, G.S., Pfau, P.R., Isenberg, G., Wong, R.C., Chak, A., Patient tolerance and acceptance of unsedated ultrathin esophagoscopy (2002) Gastrointest Endosc, 55, pp. 620-623. , 10.1067/mge.2002.123274, 11979240; Dean, R., Kulwinder, D., Massey, B., Berger, W., Walter, J., Hogan, Reza, S., A comparative study of unsedated transnasal esophagogastroduodenoscopy and conventional EGD (1996) Gastrointest Endosc, 44, pp. 422-424. , 10.1016/S0016-5107(96)70092-5, 8905361; Yagi, J., Adachi, K., Arima, N., Tanaka, S., Ose, T., Azumi, T., Sasaki, H., Kinoshita, Y., A prospective randomized comparative study on the safety and tolerability of transnasal esophagogastroduodenoscopy (2005) Endoscopy, 37, pp. 1226-1231. , 10.1055/s-2005-921037, 16329022; Davies, A.E., Kidd, D., Stone, S.P., MacMahon, J., Pharyngeal sensation and gag reflex in healthy subjects (1995) Lancet, 345, pp. 487-488. , 10.1016/S0140-6736(95)90584-7, 7861875; Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Lisheng, L., Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study (2004) Lancet, 364, pp. 937-952. , 10.1016/S0140-6736(04)17018-9, 15364185; Poulain, M., Doucet, M., Major, G.C., Drapeau, V., Series, F., Boulet, L.P., Tremblay, A., Maltais, F., The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies (2006) CMAJ, 174, pp. 1293-1299. , 1435949, 16636330; Adams, J.P., Murphy, P.G., Obesity in anaesthesia and intensive care (2000) Br J Anaesth, 85, pp. 91-108. , 10.1093/bja/85.1.91, 10927998; Faigel, D.O., Baron, T.H., Goldstein, J.L., Hirota, W.K., Jacobson, B.C., Johanson, J.F., Leighton, J.A., Wheeler-Harbaugh, J., Guidelines for the use of deep sedation and anesthesia for GI endoscopy (2002) Gastrointest Endosc, 56, pp. 613-617. , 10.1016/S0016-5107(02)70104-1, 12397263; Restelli, L., Moretti, M.P., Todaro, C., Banfi, L., The Mallampati's scale: a study of reliability in clinical practice (1993) Minerva Anestesiol, 59, pp. 261-265",
year = "2011",
doi = "10.1186/1471-230X-11-12",
language = "English",
volume = "11",
journal = "BMC Gastroenterology",
issn = "1471-230X",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Modified mallampati classification as a clinical predictor of peroral esophagogastroduodenoscopy tolerance

AU - Huang, Hsin-Hung

AU - Lee, Meei-Shyuan

AU - Shih, Yu-Lueng

AU - Chu, Heng-Cheng

AU - Huang, Tien-Yu

AU - Hsieh, Tsai-Yuan

N1 - 被引用次數:7 Export Date: 22 March 2016 CODEN: BGMAB 通訊地址: Hsieh, T.-Y.; Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterTaiwan; 電子郵件: tyh1216@ms46.hinet.net 參考文獻: Abraham, N., Barkun, A., Larocque, M., Fallone, C., Mayrand, S., Baffis, V., Cohen, A., Joseph, L., Predicting which patients can undergo upper endoscopy comfortably without conscious sedation (2002) Gastrointest Endosc, 56, pp. 180-189. , 10.1016/S0016-5107(02)70175-2, 12145594; Zaman, A., Hapke, R., Sahagun, G., Katon, R.M., Unsedated peroral endoscopy with a video ultrathin endoscope: patient acceptance, tolerance, and diagnostic accuracy (1998) Am J Gastroenterol, 93, pp. 1260-1263. , 10.1111/j.1572-0241.1998.00406.x, 9707048; Mulcahy, H.E., Kelly, P., Banks, M.R., Connor, P., Patchet, S.E., Farthing, M.J., Fairclough, P.D., Kumar, P.J., Factors associated with tolerance to, and discomfort with, unsedated diagnostic gastroscopy (2001) Scand J Gastroenterol, 36, pp. 1352-1357. , 10.1080/003655201317097245, 11761029; Waring, J.P., Baron, T.H., Hirota, W.K., Goldstein, J.L., Jacobson, B.C., Leighton, J.A., Mallery, J.S., Faigel, D.O., Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy (2003) Gastrointest Endosc, 58, pp. 317-322. , 10.1067/S0016-5107(03)00001-4, 14528201; Levy, N., Abinader, E., Continuous electrocardiographic monitoring with Holter electrocardiocorder throughout all stages of gastroscopy (1977) Am J Dig Dis, 22, pp. 1091-1096. , 10.1007/BF01072863, 930908; Quine, M.A., Bell, G.D., McCloy, R.F., Charlton, J.E., Devlin, H.B., Hopkins, A., Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing, and sedation methods (1995) Gut, 36, pp. 462-467. , 10.1136/gut.36.3.462, 1382467, 7698711; Fisher, N.C., Bailey, S., Gibson, J.A., A prospective, randomized controlled trial of sedation vs. no sedation in outpatient diagnostic upper gastrointestinal endoscopy (1998) Endoscopy, 30, pp. 21-24. , 10.1055/s-2007-993723, 9548039; Froehlich, F., Schwizer, W., Thorens, J., Kohler, M., Gonvers, J.J., Fried, M., Conscious sedation for gastroscopy: patient tolerance and cardiorespiratory parameters (1995) Gastroenterology, 108, pp. 697-704. , 10.1016/0016-5085(95)90441-7, 7875472; Lazzaroni, M., Bianchi, P.G., Preparation, premedication, and surveillance (2005) Endoscopy, 37, pp. 101-109. , 10.1055/s-2004-826149, 15692924; Mallampati, S.R., Gatt, S.P., Gugino, L.D., Desai, S.P., Waraksa, B., Freiberger, D., Liu, P.L., A clinical sign to predict difficult tracheal intubation: a prospective study (1985) Can Anaesth Soc J, 32, pp. 429-434. , 10.1007/BF03011357, 4027773; Samsoon, G.L., Young, J.R., Difficult tracheal intubation: a retrospective study (1987) Anaesthesia, 42, pp. 487-490. , 10.1111/j.1365-2044.1987.tb04039.x, 3592174; Tan, C.C., Freeman, J.G., Throat spray for upper gastrointestinal endoscopy is quite acceptable to patients (1996) Endoscopy, 28, pp. 277-282. , 10.1055/s-2007-1005453, 8781790; Mahajan, R.J., Johnson, J.C., Marshall, J.B., Predictors of patient cooperation during gastrointestinal endoscopy (1997) J Clin Gastroenterol, 24, pp. 220-223. , 10.1097/00004836-199706000-00007, 9252844; Farhadi, A., Fields, J.Z., Hoseini, S.H., The assessment of esophagogastroduodenoscopy tolerance a prospective study of 300 cases (2001) Diagn Ther Endosc, 7, pp. 141-147. , 10.1155/DTE.7.141, 2362842, 18493558; Campo, R., Brullet, E., Montserrat, A., Calvet, X., Moix, J., Rue, M., Roque, M., Bordas, J.M., Identification of factors that influence tolerance of upper gastrointestinal endoscopy (1999) Eur J Gastroenterol Hepatol, 11, pp. 201-204. , 10.1097/00042737-199902000-00023, 10102233; Dumortier, J., Napoleon, B., Hedelius, F., Pellissier, P.E., Leprince, E., Pujol, B., Ponchon, T., Unsedated transnasal EGD in daily practice: results with 1100 consecutive patients (2003) Gastrointest Endosc, 57, pp. 198-204. , 10.1067/mge.2003.59, 12556784; Gelly, A.L., Farley, A., Boyer, J., Asselin, M., Spenard, J., Influence of sex, age and smoking status on patient comfort during gastroscopy with pharyngeal anesthesia by a new benzocaine-tetracaine preparation (1998) Can J Gastroenterol, 12, pp. 431-433; Soma, Y., Saito, H., Kishibe, T., Takahashi, T., Tanaka, H., Munakata, A., Evaluation of topical pharyngeal anesthesia for upper endoscopy including factors associated with patient tolerance (2001) Gastrointest Endosc, 53, pp. 14-18. , 10.1067/mge.2001.111773, 11154482; Faulx, A.L., Catanzaro, A., Zyzanski, S., Cooper, G.S., Pfau, P.R., Isenberg, G., Wong, R.C., Chak, A., Patient tolerance and acceptance of unsedated ultrathin esophagoscopy (2002) Gastrointest Endosc, 55, pp. 620-623. , 10.1067/mge.2002.123274, 11979240; Dean, R., Kulwinder, D., Massey, B., Berger, W., Walter, J., Hogan, Reza, S., A comparative study of unsedated transnasal esophagogastroduodenoscopy and conventional EGD (1996) Gastrointest Endosc, 44, pp. 422-424. , 10.1016/S0016-5107(96)70092-5, 8905361; Yagi, J., Adachi, K., Arima, N., Tanaka, S., Ose, T., Azumi, T., Sasaki, H., Kinoshita, Y., A prospective randomized comparative study on the safety and tolerability of transnasal esophagogastroduodenoscopy (2005) Endoscopy, 37, pp. 1226-1231. , 10.1055/s-2005-921037, 16329022; Davies, A.E., Kidd, D., Stone, S.P., MacMahon, J., Pharyngeal sensation and gag reflex in healthy subjects (1995) Lancet, 345, pp. 487-488. , 10.1016/S0140-6736(95)90584-7, 7861875; Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Lisheng, L., Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study (2004) Lancet, 364, pp. 937-952. , 10.1016/S0140-6736(04)17018-9, 15364185; Poulain, M., Doucet, M., Major, G.C., Drapeau, V., Series, F., Boulet, L.P., Tremblay, A., Maltais, F., The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies (2006) CMAJ, 174, pp. 1293-1299. , 1435949, 16636330; Adams, J.P., Murphy, P.G., Obesity in anaesthesia and intensive care (2000) Br J Anaesth, 85, pp. 91-108. , 10.1093/bja/85.1.91, 10927998; Faigel, D.O., Baron, T.H., Goldstein, J.L., Hirota, W.K., Jacobson, B.C., Johanson, J.F., Leighton, J.A., Wheeler-Harbaugh, J., Guidelines for the use of deep sedation and anesthesia for GI endoscopy (2002) Gastrointest Endosc, 56, pp. 613-617. , 10.1016/S0016-5107(02)70104-1, 12397263; Restelli, L., Moretti, M.P., Todaro, C., Banfi, L., The Mallampati's scale: a study of reliability in clinical practice (1993) Minerva Anestesiol, 59, pp. 261-265

PY - 2011

Y1 - 2011

N2 - Background: Unsedated esophagogastroduodenoscopy (EGD) is simpler and safer than sedated EGD; however, approximately 40% of patients cannot tolerate it. Early identification of patients likely to poorly tolerate unsedated EGD is valuable for improving compliance. The modified Mallampati classification (MMC) has been used to evaluate difficult tracheal intubation and laryngoscope insertion. We tried to assess the efficacy of MMC to predict the tolerance of EGD in unsedated patients.Methods: Two hundred patients who underwent an unsedated diagnostic EGD were recruited. They were stratified according to the view of the oropharynx as either MMC class I + II (good view) or class III + IV (poor view). EGD tolerance was assessed in three ways: gag reflex by endoscopist assessment, patient satisfaction by interview, and the degree of change in vital signs.Results: MMC was significantly correlated to gag reflex (P <0.001), patient satisfaction (P = 0.028), and a change of vital signs (P = 0.024). Patients in the poor view group had a 3.87-fold increased risk of gag reflex (P <0.001), a 1.78-fold increased risk of unsatisfaction (P = 0.067), and a 1.96-fold increased risk of a change in vital signs (P = 0.025) compared to those in the good view group.Conclusions: MMC appears to be a clinically useful predictor of EGD tolerance. Patients with poor view of oropharynx by MMC criteria may be candidates for sedated or transnasal EGD. © 2011 Huang et al; licensee BioMed Central Ltd.

AB - Background: Unsedated esophagogastroduodenoscopy (EGD) is simpler and safer than sedated EGD; however, approximately 40% of patients cannot tolerate it. Early identification of patients likely to poorly tolerate unsedated EGD is valuable for improving compliance. The modified Mallampati classification (MMC) has been used to evaluate difficult tracheal intubation and laryngoscope insertion. We tried to assess the efficacy of MMC to predict the tolerance of EGD in unsedated patients.Methods: Two hundred patients who underwent an unsedated diagnostic EGD were recruited. They were stratified according to the view of the oropharynx as either MMC class I + II (good view) or class III + IV (poor view). EGD tolerance was assessed in three ways: gag reflex by endoscopist assessment, patient satisfaction by interview, and the degree of change in vital signs.Results: MMC was significantly correlated to gag reflex (P <0.001), patient satisfaction (P = 0.028), and a change of vital signs (P = 0.024). Patients in the poor view group had a 3.87-fold increased risk of gag reflex (P <0.001), a 1.78-fold increased risk of unsatisfaction (P = 0.067), and a 1.96-fold increased risk of a change in vital signs (P = 0.025) compared to those in the good view group.Conclusions: MMC appears to be a clinically useful predictor of EGD tolerance. Patients with poor view of oropharynx by MMC criteria may be candidates for sedated or transnasal EGD. © 2011 Huang et al; licensee BioMed Central Ltd.

KW - adult

KW - age distribution

KW - aged

KW - anxiety

KW - article

KW - body mass

KW - clinical trial

KW - controlled clinical trial

KW - controlled study

KW - esophagogastroduodenoscopy

KW - female

KW - gastroesophageal reflux

KW - human

KW - interview

KW - major clinical study

KW - male

KW - mean arterial pressure

KW - medical specialist

KW - modified mallampati classification

KW - non invasive measurement

KW - oropharynx

KW - oxygen saturation

KW - patient education

KW - patient satisfaction

KW - peptic ulcer

KW - peroral esophagogastroduodenoscopy tolerance

KW - physical tolerance

KW - prediction

KW - pulse rate

KW - reliability

KW - sensitivity and specificity

KW - sex difference

KW - smoking

KW - adolescent

KW - blood pressure

KW - digestive tract endoscopy

KW - evaluation

KW - gastrointestinal symptom

KW - glottis

KW - heart rate

KW - histology

KW - middle aged

KW - palate

KW - physiology

KW - predictive value

KW - retrospective study

KW - soft palate

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Blood Pressure

KW - Endoscopy, Digestive System

KW - Female

KW - Gagging

KW - Gastroesophageal Reflux

KW - Glottis

KW - Heart Rate

KW - Humans

KW - Male

KW - Middle Aged

KW - Palate, Soft

KW - Patient Satisfaction

KW - Peptic Ulcer

KW - Predictive Value of Tests

KW - Retrospective Studies

KW - Uvula

KW - Young Adult

U2 - 10.1186/1471-230X-11-12

DO - 10.1186/1471-230X-11-12

M3 - Article

VL - 11

JO - BMC Gastroenterology

JF - BMC Gastroenterology

SN - 1471-230X

ER -