Assessment using the SAVE Score predicts difficulty of tracheal intubation in the intensive care uni
Geisinger Commonwealth School of Medicine
Introduction The SAVE (Sorour Airway Visualization Evaluation) score is a novel, objective method to simply and accurately predict the difficulty of intubating a patient. The score is an integrated calculation that combines various aspects which influence the difficulty of performing an intubation and can be calculated in under 90 seconds. This study aims to assess the validity of this scoring tool as a means by which clinicians can predict the difficulty of completing an intubation in the intensive care unit. Methods Over the course of 2 years, residents in the ICU at Signature Healthcare Brockton Hospital, performed intubations, calculated patient’s SAVE scores, and evaluated laryngeal view after intubation. This score was not used to change clinical decision making as the data was collected after each encounter and statistical analysis was retrospectively completed. Results The SAVE score predicted the difficulty of intubation with a sensitivity of 88.9% (95% CI: 51.8% to 99.7%) and specificity at 95.7% (95% CI: 87.8%-99.1%), as well as a positive predictive value of 72.7% (95% CI: 45.8%-89.4%) and negative predictive value of 98.5% (95% CI: 91.2% to 99.8%). These calculation were derived by comparing the SAVE score to the difficulty of intubation assessed via laryngeal view. Conclusion The SAVE airway assessment score successfully predicts the difficulty of an intubation with a high negative predictive value, sensitivity, and specificity proving itself to be an effective and simple method of intubation assessment in the ICU. Given its success as an assessment tool for difficult airway prediction, SAVE has the potential to be implemented in the ICU as a fast and effective process by which clinicians can recognize patients that may warrant a higher skill level or more advance intubation methods.