macocha_score: MACOCHA Score for Difficult Intubation in ICU

In cliot: Clinical Indices and Outcomes Tools

MACOCHA Score for Difficult Intubation in ICU

Description

Calculates the MACOCHA score to predict the risk of difficult endotracheal intubation specifically in critically ill patients in the Intensive Care Unit (ICU). A score of 3 or greater identifies patients at high risk for difficult intubation.

Usage

macocha_score(mallampati_iii_iv, apnea_syndrome, cervical_spine_limited,
              mouth_opening_lt_3cm, coma_gcs_lt_8, hypoxia_severe,
              non_anesthesiologist)

Arguments

mallampati_iii_iv	Numeric (0 or 1). Mallampati Score III or IV. (1 = Yes, +5 points).
apnea_syndrome	Numeric (0 or 1). Obstructive Sleep Apnea Syndrome (OSAS). (1 = Yes, +2 points).
cervical_spine_limited	Numeric (0 or 1). Reduced mobility of the cervical spine. (1 = Yes, +1 point).
mouth_opening_lt_3cm	Numeric (0 or 1). Limited mouth opening (< 3 cm). (1 = Yes, +1 point).
coma_gcs_lt_8	Numeric (0 or 1). Coma (Glasgow Coma Scale < 8). (1 = Yes, +1 point).
hypoxia_severe	Numeric (0 or 1). Severe hypoxia (SpO2 < 80% despite preoxygenation). (1 = Yes, +1 point).
non_anesthesiologist	Numeric (0 or 1). Operator is a non-anesthesiologist. (1 = Yes, +1 point).

Value

A list containing:

MACOCHA_Score	The calculated score (Range 0-12).
Risk_Category	"Low Risk" (Score 0-2) or "High Risk" (Score >= 3).
Recommendation	Clinical guidance for airway management preparation.

References

De Jong A, Molinari N, Terzi N, et al. Early identification of patients at risk of difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study. Am J Respir Crit Care Med. 2013;187(8):832-839. doi:10.1164/rccm.201210-1851OC

Examples

# Example 1: High Risk
# Mallampati III (+5), Coma (+1)
# Score = 6
macocha_score(1, 0, 0, 0, 1, 0, 0)

# Example 2: Low Risk
# OSAS (+2), No other factors
# Score = 2
macocha_score(0, 1, 0, 0, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.