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Site involvement as a predictor of airway intervention in angioedema
Author(s) -
McCormick Michael,
Folbe Adam J.,
Lin HoSheng,
Hooten Joanna,
Yoo George H.,
Krouse John H.
Publication year - 2011
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21277
Subject(s) - airway , medicine , angioedema , larynx , laryngoscopy , intervention (counseling) , tracheotomy , tongue , intubation , epiglottis , medical record , demographics , airway obstruction , surgery , pathology , nursing , demography , sociology
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.