Usefulness of the Cameron tracheostomy scoring system after oral tumor surgery

Objectives: 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. Material and 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. Conclusion: The decision to perform an ET for oral tumor surgery can be enhanced using the PS of Cameron based on objective data. (C) 2013 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L. All rights reserved.