EBMcalc Medical Calculator

Wilson Score for Prediction of Difficult Intubation

Input

Weight

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) Moderate (1) Severe (2)

Prominent Incisors None (0) Moderate (1) Severe (2)

Result

Important: Inputs must be complete to perform calculation.

Wilson Score

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)

Data action

Include literature references: Yes No

Notes

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.

References

Wilson ME, Spiegelhalter D, Robertson JA, Lesser P. Predicting difficult intubation. Br J Anaesth. 1988 Aug;61(2):211-6. PubMed ID: 3415893
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

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 8335-2 : kg 75292-3 : kg 3142-7 : kg

This material contains content from LOINC (http://loinc.org). LOINC is copyright © 1995-2023, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.

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