Lin et al reported a model for predicting the airway for a patient with a deep neck space abscess. This can help to identify a patient who may require more aggressive management. The authors are from Sun Yat-Sen University in Guandong.
Patient selection: deep neck space abscess
Parameters:
(1) percent neutrophil as a decimal fraction
(2) platelet to lymphocyte ratio (PLR)
(3) serum albumin in g/L
(4) multispace involvement
(5) gas formation
(6) suprahyoid involvement
(7) retropharyngeal involvement
(8) dyspnea
points for NEUT =
= (142.857 * (NEUT)) - 42.857
points for PLR =
= 0.0833 * (PLR))
points for serum albumin =
= 129.8 - (2.36 * (albumin))
|
Parameter
|
Finding
|
Points
|
|
multispace involvement
|
no
|
0
|
|
|
yes
|
29.1
|
|
gas
|
no
|
0
|
|
|
yes
|
24.7
|
|
suprahyoid
|
no
|
0
|
|
|
yes
|
24.2
|
|
retropharyngeal
|
no
|
0
|
|
|
yes
|
47.2
|
|
dyspnea
|
no
|
0
|
|
|
yes
|
36.2
|
where:
• It is unclear how to count regions of involvement. Based on Table 2 only one (suprahyoid, retropharyngeal) site should be counted. But the nomogram allows for both rather than including both as 1 variable.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 431
value of X =
= (0.06625 * (score)) - 15.47
probability of requiring airway support =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.95.
