MACOCHA Score (ICU difficult intubation)
MACOCHA score (De Jong 2013): predicts difficult intubation in the ICU from patient, pathology, and operator factors (0–12); ≥ 3 flags elevated risk.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Mallampati III or IV
- Yes
- Obstructive sleep apnea syndrome
- Yes
Result: MACOCHA score 7: elevated difficult-intubation risk (>= 3) -- prepare for a difficult airway.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Risk
- higher = greater risk; >= 3 flags elevated difficult-intubation risk (sensitivity 73%, NPV 98% in validation).
What you enter
- Mallampati III or IV
- Obstructive sleep apnea syndrome
- Reduced cervical-spine mobility
- Limited mouth opening < 3 cm
- Coma
- Severe hypoxemia (SpO₂ < 80%)
- Non-anesthesiologist operator
How this is calculated
- Items
- Mallampati III/IV +5, OSA +2, reduced cervical mobility +1, mouth opening < 3 cm +1, coma +1, SpO2 < 80% +1, non-anesthesiologist +1 (total 0-12).
De Jong A, Molinari N, Terzi N, et al. Early identification of patients at risk for 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. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.