Site involvement as a predictor of airway intervention in angioedema. Laryngoscope 2011 Feb;121(2):262-6
Date
01/29/2011Pubmed ID
21271571DOI
10.1002/lary.21277Scopus ID
2-s2.0-79251552284 (requires institutional sign-in at Scopus site) 22 CitationsAbstract
OBJECTIVES/HYPOTHESIS: To look for a relationship between which sites are involved in angioedema and the need for airway intervention (intubation, tracheotomy).
STUDY DESIGN: Retrospective chart review.
METHODS: Charts of 140 patients who were admitted to two hospitals at an academic medical center between July 1, 2006 and June 30, 2008 with the diagnosis of angioedema were reviewed. Charts were reviewed for pertinent data, including demographics, sites of involvement along the upper airway, medical therapy, and airway intervention. Subsites included lips, anterior tongue, floor of mouth, soft palate, base of tongue (BOT), and larynx.
RESULTS: The BOT was involved in 19 patients and the larynx was involved in 29 patients. Airway intervention was required in 21 patients (16%). Patients with laryngeal and/or BOT involvement required intervention in 38% of cases (vs. 7% in patients without involvement). Patients with more than three sites involved had a 39% rate of intervention, compared with only 12% in patients with less than three sites involved. Among those patients with laryngeal/BOT involvement, 56% with more than three sites involved required intervention, as compared to 30% of patients with less than three sites involved.
CONCLUSIONS: Site of involvement was found to correlate with airway intervention. Involvement of anterior tongue, BOT, and larynx significantly increased the likelihood of intubation or tracheostomy, as did involvement of multiple sites. Thorough evaluation, including fiberoptic laryngoscopy, can aid in determining which patients require airway intervention.
Author List
McCormick M, Folbe AJ, Lin HS, Hooten J, Yoo GH, Krouse JHAuthor
Michael E. McCormick MD Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Angioedema
Female
Humans
Intubation, Intratracheal
Laryngeal Diseases
Laryngoscopy
Male
Middle Aged
Retrospective Studies
Tongue Diseases
Tracheotomy