[Usefulness of the Cameron tracheostomy scoring system after oral tumor surgery].
OBJECTIVE
The aim of this study was to analyze the results of applying the predictive score (PS) of Cameron to perform elective tracheostomy (ET) in oral tumor surgery.


METHODS
A retrospective and descriptive study was conducted on consecutive patients undergoing oral tumor surgery between January 2010 and December 2012. Items of the PS were collected: reconstruction and type of graft, mandibulectomy, bilateral neck dissection, and tumor location. Patients were grouped according to the management of the airway at the end of surgery into 4 groups: extubated, intubated, ET, and urgent tracheostomy. A cutoff of≥5 points PS was considered for conducting ET.


RESULTS
A total of 90 patients were included. Group distribution was: extubated=27.8%, intubated=17.8%, ET=53.3%, and one case (1.1%) of urgent tracheostomy. Using the cutoff value of PS≥5 points yielded a diagnostic sensitivity value of 0.7 for a 95% confidence interval (CI) (0.57 to 0.82), and a diagnostic specificity value of 0.9 (95% CI 0.79 to 0.99). The PPV was 0.9 (95% CI 0.81 to 0.99) and the NPV was 0.67 (95% CI 0.54 to 0.8). The AUC gave a value of 0.87 (standard error 0.36). The likelihood ratio was 6.48.


CONCLUSIONS
The decision to perform an ET for oral tumor surgery can be enhanced using the PS of Cameron based on objective data.
Servicio de Anestesiología, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: jbenatar@telefonica.net.
J
J
Benatar-Haserfaty
Servicio de Cirugía Maxilofacial, Hospital Universitario Ramón y Cajal, Madrid, España.
M
M
Picón-Molina
Servicio de Anestesiología, Hospital Universitario Ramón y Cajal, Madrid, España.
D A
DA
Meléndez-Salinas
Servicio de Anestesiología, Hospital Universitario Ramón y Cajal, Madrid, España.
C
C
Palacios-López
D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation; D019540:Area Under Curve; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D037981:Neck Dissection; D019647:Oral Surgical Procedures; D056948:Orthognathic Surgical Procedures; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014139:Tracheostomy
Airway management; Complicaciones; Complications; Cáncer de cabeza y cuello; Endotracheal extubation; Extubación; Head and neck cancer; Manejo de la vía aérea; Score; Tracheostomy; Traqueostomía