GENERAL ARTICLE Difficult Tracheal Intubation Is More Common in Obese Than in Lean Patients

Whether tracheal intubation is more difficult in obese patients is debatable. We compared the incidence of dif-ficult tracheal intubation in obese and lean patients by using a recently validated objective scale, the intuba-tion difficulty scale (IDS). We studied 134 lean (body mass index,30 kg/m2) and 129 obese (body mass in-dex, 35 kg/m2) consecutive patients. The IDS scores, categorized as difficult intubation (IDS 5) or not (IDS 5), and the patient data, including oxygen saturation (SpO2) while breathing oxygen, were compared be-tween lean and obese patients. In addition, risk factors for difficult intubation were determined in obese pa-tients. The IDS score was 5 in 3 lean and 20 obese pa-tients (P 0.0001). A Mallampati score of III–IV was the only independent risk factor for difficult intubation i