开发一种新型评分工具以预测创伤患者早期环甲膜切开术的需求。
Development of a novel scoring tool to predict the need for early cricothyroidotomy in trauma patients.
作者信息
Londoño Mary, Nahmias Jeffry, Dolich Matthew, Lekawa Michael, Kong Allen, Schubl Sebastian, Inaba Kenji, Grigorian Areg
机构信息
University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
University of Southern California, Department of Surgery, Los Angeles, CA, USA.
出版信息
Surg Open Sci. 2023 Sep 20;16:58-63. doi: 10.1016/j.sopen.2023.09.017. eCollection 2023 Dec.
BACKGROUND
The lack of a widely-used tool for predicting early cricothyroidotomy in trauma patients prompted us to develop the Cricothyroidotomy After Trauma (CAT) score. We aimed to predict the need for cricothyroidotomy within one hour of trauma patient arrival.
METHODS
Derivation and validation datasets were obtained from the Trauma Quality Improvement Program (TQIP) database. Logistic modeling identified predictors, and weighted averages were used to create the CAT score. The score's performance was assessed using AUROC.
RESULTS
Among 1,373,823 derivation patients, <1 % ( = 339) underwent cricothyroidotomy within one hour. The CAT score, comprising nine predictors, achieved an AUROC of 0.88. Severe neck injury and gunshot wound were the strongest predictors. Cricothyroidotomy rates increased from 0.4 % to 9.3 % at scores of 5 and 8, respectively. In the validation set, the CAT tool yielded an AUROC of 0.9.
CONCLUSION
The CAT score is a validated tool for predicting the need for early cricothyroidotomy in trauma patients. Further research is necessary to enhance its utility and assess its value in trauma care.
背景
缺乏一种广泛应用于预测创伤患者早期环甲膜切开术的工具促使我们开发创伤后环甲膜切开术（CAT）评分。我们旨在预测创伤患者到达后一小时内是否需要进行环甲膜切开术。
方法
从创伤质量改进计划（TQIP）数据库中获取推导数据集和验证数据集。逻辑建模确定预测因素，并使用加权平均值来创建CAT评分。使用受试者工作特征曲线下面积（AUROC）评估该评分的性能。
结果
在1373823例推导患者中，不到1%（n = 339）在一小时内接受了环甲膜切开术。包含九个预测因素的CAT评分的AUROC为0.88。严重颈部损伤和枪伤是最强的预测因素。在评分为5分和8分时，环甲膜切开术的发生率分别从0.4%增加到9.3%。在验证集中，CAT工具的AUROC为0.9。
结论
CAT评分是一种经过验证的工具，可用于预测创伤患者早期环甲膜切开术的需求。需要进一步研究以提高其效用并评估其在创伤护理中的价值。
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