Predictive value of four scoring systems on judging the need for tracheostomy in patients with oral cancers

doi:10.19438/j.cjoms.2022.02.005

Abstract

Abstract: PUPPOSE: This study was to assess and compare the predictive value of Kruse, Cameron, CASST and TRACHY tracheostomy scoring system on the need for tracheostomy in patients with oral cancers. METHODS: A retrospective analysis was conducted of clinical data of patients with oral cancers admitted to the Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Nanjing Medical University from December 2017 to July 2021. The clinical data were converted into total score of each scoring system, and the calculation and assessment were examined based on the recommended threshold. Receiver operating characteristic curve(ROC) analysis was used to examine the optimal threshold to reassess according to Youden index. The predictive value was compared by applying the area under receiver operating curve (AUC). The data were analyzed using SPSS 26.0 software package and MedCalc 20.0 software. RESULTS: Two hundred and thirty five cases were included in this retrospective study and the rate of tracheotomy rate was 9.8%(23/235). No emergency surgical airway management was performed after operation, and all patients were discharged with stable condition. All score systems performed poor positive predictive value before or after adjustment (0.28-0.4/0.19-0.45), the sensitivity was 0.39-0.91/0.87-0.91, the specificity was 0.75-0.93/0.61-0.88. AUC from greater to smaller was arranged as Cameron, TRACHY, CASST, Kruse tracheostomy scoring systems. There was significant difference of AUC between Cameron and Kruse scoring system(Z=2.014,P<0.05), Cameron and CASST scoring system (Z=1.996,P<0.05). CONCLUSIONS: Instead of effectively judging the need for tracheotomy, these four scoring systems may lead to a higher tracheostomy rate.

Key words: Oral cancer, Tracheostomy, Scoring system

CLC Number:

R782.05

ZHU Bo-wen, ZHUANG Hai, Mao Qiu-yi, BU Shou-shan. Predictive value of four scoring systems on judging the need for tracheostomy in patients with oral cancers[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(2): 129-134.

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