Development of a novel scoring tool to predict the need for early cricothyroidotomy in trauma patients

Mary Londoño, BS; Jeffry Nahmias, MD, MHPE; Matthew Dolich, MD; Michael Lekawa, MD; Allen Kong, MD; Sebastian Schubl, MD, FACS; Kenji Inaba, MD; Areg Grigorian, MD

Surgery Open Science (Dec 2023)

Development of a novel scoring tool to predict the need for early cricothyroidotomy in trauma patients

Mary Londoño, BS,
Jeffry Nahmias, MD, MHPE,
Matthew Dolich, MD,
Michael Lekawa, MD,
Allen Kong, MD,
Sebastian Schubl, MD, FACS,
Kenji Inaba, MD,
Areg Grigorian, MD

Affiliations

Mary Londoño, BS: University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
Jeffry Nahmias, MD, MHPE: University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
Matthew Dolich, MD: University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
Michael Lekawa, MD: University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
Allen Kong, MD: University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
Sebastian Schubl, MD, FACS: University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
Kenji Inaba, MD: University of Southern California, Department of Surgery, Los Angeles, CA, USA
Areg Grigorian, MD: University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA; Corresponding author at: Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA 92868-3298, USA.

Journal volume & issue: Vol. 16
pp. 58 – 63

Abstract

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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 % (n = 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.

Published in Surgery Open Science

ISSN: 2589-8450 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-open-science/

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