Abstract
Objectives
To analyze the clinical utility of a clinical risk scale to predict the need for advanced airway management in patients with deep neck abscess.
Methods
Observational, analytical, cross-sectional study. Patients over 18 years old, both genders, with surgical management of a deep neck abscess, between January 1st, 2015 to December 31th, 2021, who were applied the clinical risk scale (https://7-414-5-19.shinyapps.io/ClinicalRiskScore/). The sensitivity, specificity, and predictive values of the scale were calculated based on the identified clinical outcomes. A p < 0.05 was considered significant.
Results
A sample of 213 patients was obtained, 121 (56.8%) men, of whom 50 (23.5%) required advanced airway management. Dyspnea was the variable with the most statistical weight in our study, (p = 0.001) as well as the multiple spaces involvement, (p = 0.001) the presence of air corpuscles, (p = 0.001) compromise of the retropharyngeal space (p = 0.001) and age greater than 55 years (p = 0.001). Taking these data into account, were found for the clinical risk scale a sensitivity of 97% and a specificity of 65% (p = 0.001, 95% CI 0.856-0.984).
Conclusions
The clinical risk scale developed to predict advanced airway management in patients with a diagnosis of deep neck abscess may be applicable in our environment with high sensitivity and specificity.
Level of evidence: IV.
Keywords
Abscess; Neck; Scale; Intubation; Risk
Highlights
Deep neck abscesses are one of the most dangerous emergencies in otolaryngology.
The principal complication in deep neck abscesses is airway obstruction.
It is difficult to predict which patients will require Advance Airway Management.
Some factors have been used to create scales to stratify the risk of complications.
The benefit of a risk scale is to prevent requirement of advanced airway management.
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