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  Wilson Score for Prediction of Difficult Intubation

C Spine Mobility  
Jaw Mobility IG ≥5 cm or normal ability to protrude lower teeth beyond upper (0)

IG <5 cm and can only protrude lower teeth to level of upper (1)

IG <5 cm and unable to protrude lower teeth to meet upper (2)
Retrognathia None (0)

Moderare (1)

Severe (2)
Prominent Incisors None (0)

Moderate (1)

Severe (2)

Wilson Score  

Include literature references: Yes   No

  Wilson Score Interpretation

0 to 1 point: No added difficulty
2 to 3 points: Difficult intubation (72-75% sensitivity)
4 to 10 points: Difficult intubation (36-42% sensitivity)

  • IG: interincisor gap.

Equations used
WilsonScore = WeightFactor + CSpineMobilityFactor + JawMobility + Retrognathia + ProminentIncisors


Calculation Details and Variables
  • WeightFactor is assigned values by this ordered logic:
    • If Weight >110 kg WeightFactor = 2
    • Else if Weight ≥90 kg WeightFactor = 1
    • Else WeightFactor = 0.
  • CSpineMobilityFactor is assigned values by this ordered logic:
    • If C Spine Mobility <90 degrees CSpineMobilityFactor = 2
    • Else if C Spine Mobility >90 degrees CSpineMobilityFactor = 0
    • Else CSpineMobilityFactor = 1.
  • Equation parameters such as Jaw Mobility, have two or more discrete values that may be used in the calculation. The numbers in the parentheses, e.g. (0), represent the values that will be used.

  1. Wilson ME, Spiegelhalter D, Robertson JA, Lesser P. Predicting difficult intubation. Br J Anaesth. 1988 Aug;61(2):211-6. PubMed ID: 3415893 PubMed Logo
  2. Detsky ME, Jivraj N, Adhikari NK, et al. Will This Patient Be Difficult to Intubate?: The Rational Clinical Examination Systematic Review. JAMA. 2019 Feb 5;321(5):493-503. PubMed ID: 32207774 PubMed Logo

Associated Medical Subject Headings [MeSH]
         Adult,   Anthropometry,   Head,   Humans,   Intratracheal,   Intubation,   Laryngoscopy,   Larynx,   Middle Aged,   Neck,   Prospective Studies,   Risk Factors

Associated Logical Observation Identifiers Names and Codes [LOINC]
Parameter LOINC's and Suggested Units
Weight 29463-7 : kg      3141-9 : kg      8350-1 : kg      8351-9 : kg      79348-9 : kg      

This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

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