Abstract:

Objective

To evaluate the effectiveness of the Difficult Airway PHysiological Score（DAPS） in predicting physiologically difficult airways and associated adverse outcomes in the emergency medicine department.

Methods

This retrospective， single-center study was conducted using data from the Department of Emergency Medicine of Hebei University Affiliated Hospital from 2023 to 2024. A total of 271 eligible adult intubation patients were included and divided into a high-risk group （DAPS≥10） and a lowrisk group （DAPS＜10） based on their DAPS scores. Primary outcomes included the incidence of adverse events such as hypotension， hypoxemia， cardiac arrest， and death within 1 hour post-intubation. Statistical analyses included t-tests， chi-square tests， and receiver operating characteristic （ROC） curve analysis.

Results

Of the 271 patients， 62.4% were male， and 60.6% were aged ≥45 years. Respiratory distress and coma were the main reasons for intubation， accounting for 75.3% and 66.4% of cases， respectively. The incidence of adverse events was significantly higher in the high-risk group than in the low-risk group， including hypotension （51.6% vs 16.4%）， hypoxemia （31.4% vs 14.3%）， cardiac arrest （23.3% vs 8%）， and death within 1 hour post-intubation （32.1% vs 15.2%） （all P＜0.001）. The area under the ROC curve for DAPS was 0.813，demonstrating good predictive performance.

Conclusion

DAPS is an effective tool for early identification of patients with physiologically difficult airways and associated adverse outcomes in the emergency medicine department， aiding clinicians in risk stratification and management.

Key words: Endotracheal intubation, Physiologically difficult airway, Adverse outcomes, Predictive value