A classification and regression tree to assist clinical decision making in airway management for patients with cervical spinal cord injury.
METHODS
This was a prospective observational study.


OBJECTIVE
To review airway management of patients with acute cervical spinal cord injury (CSCI) who are admitted to the intensive care unit (ICU) and to develop a classification and regression tree (CART) to direct clinical decision making in airway management.


METHODS
This study was carried out in Australia.


METHODS
All patients with CSCI who required intubation and mechanical ventilation and who were admitted to ICU in three tertiary hospitals in Melbourne between October 2004 and May 2009 and two other interstate hospitals between December 2004 and December 2005 were included. Airway management was recorded.


RESULTS
A total of 114 patients were included. Tracheostomy insertion occurred in 68 patients (59.7%). Using CART analysis, it was found that the variables forced vital capacity, the volume of pulmonary secretion and gas exchange were predictive of airway management on 82.3% occasions with an 8.7% extubation failure rate.


CONCLUSIONS
A CART can be useful in clinical decision making regarding airway management in CSCI.
Berney
S C
SC
Austin Hospital Melbourne, Melbourne, Victoria, Australia. sue.berney@austin.org.au
Gordon
I R
IR
Opdam
H I
HI
Denehy
L
L
D000328:Adult; D058109:Airway Management / Q000379:methods* / Q000639:trends; D001237:Asphyxia / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D001315:Australia / Q000453:epidemiology; D002985:Clinical Protocols / Q000592:standards*; D003663:Decision Trees; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012133:Respiratory Paralysis / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D013119:Spinal Cord Injuries / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult