Clinical assessment scoring system for tracheostomy (CASST) criterion: Objective criteria to predict pre-operatively the need for a tracheostomy in head and neck malignancies

被引：29

作者：

Gupta, Karan ^{[1
]}

Mandlik, Dushyant ^{[1
]}

Patel, Daxesh ^{[1
]}

Patel, Purvi ^{[1
]}

Shah, Bankim ^{[2
]}

Vijay, Devanhalli G. ^{[3
]}

Kothari, Jagdish M. ^{[3
]}

Toprani, Rajendra B. ^{[1
]}

Patel, Kaustubh D. ^{[1
]}

机构：

[1] Aastha Oncol Associates, Dept Head & Neck Surg Oncol, HCG Canc Ctr, Ahmadabad, Gujarat, India

[2] HCG Canc Ctr, Dept Anaesthesiol & Crit Care, Ahmadabad, Gujarat, India

[3] Aastha Oncol Associates, Dept Surg Oncol, HCG Canc Ctr, Ahmadabad, Gujarat, India

来源：

JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY | 2016年 / 44卷 / 09期

关键词：

Oral and oropharyngeal cancer; Tracheostomy; Risk analysis system; Airway management; ELECTIVE TRACHEOSTOMY; COMPLICATIONS; MANAGEMENT; SURGERY; TRACHEOTOMY; INTUBATION; CANCER; AIRWAY;

D O I：

10.1016/j.jcms.2016.07.008

中图分类号：

R78 [口腔科学];

学科分类号：

1003 ;

摘要：

Background: Tracheostomy is a mainstay modality for airway management for patients with head-neck cancer undergoing surgery. This study aims to define factors predicting need of tracheostomy and define an effective objective criterion to predict tracheostomy need. Methods: 486 patients undergoing composite resections were studied. Factors analyzed were age, previous surgery, extent of surgery, trismus, extent of mandibular resection and reconstruction etc. Factors were divided into major and minor, using the clinical assessment scoring system for tracheostomy (CASST) criterion. Results: Sixty seven (13.7%) patients required tracheostomy for their peri-operative management. Elective tracheostomies were done in 53 cases during surgery and post-operatively in 14 patients. All patients in whom tracheostomies were anticipated had a score of seven or more. Conclusion: A decision on whether or not an elective tracheotomy in head and neck surgery is necessary and can be facilitated using CASST criterion, which has a sensitivity of 95.5% and a negative predictive value (NPV) of 99.3%. It may reduce post-operative complications and contribute to safer treatment. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

引用

页码：1310 / 1313

页数：4