Evaluation of staging criteria for disposition and airway intervention in emergency department angioedema patients

Conor Dass; Maggie Mahaffa; Elizabeth Dang; Ronna Campbell; Zuhair Ballas; Sangil Lee

doi:10.1002/ams2.704

Back

Evaluation of staging criteria for disposition and airway intervention in emergency department angioedema patients

Journal article

Open access

Peer reviewed

Evaluation of staging criteria for disposition and airway intervention in emergency department angioedema patients

Conor Dass, Maggie Mahaffa, Elizabeth Dang, Ronna Campbell, Zuhair Ballas and Sangil Lee

Acute medicine & surgery, Vol.8(1), pp.e704-n/a

01/01/2021

DOI: 10.1002/ams2.704

PMCID: PMC8548721

PMID: 34729186

Files and links (1)

url

https://doi.org/10.1002/ams2.704View

Published (Version of record) Open Access

Abstract

Aim: Angioedema is a nonpitting edema that can lead to death secondary to airway obstruction. Previously, a staging system based on localization of the angioedema was proposed for risk stratification of likelihood of need for admission or airway intervention. This study aims to evaluate a staging system based on angioedema localization as a method of predicting need for admission or airway intervention. Methods: This was a retrospective chart review of angioedema cases that presented to an academic emergency department (ED) from August 1, 2006, to January 31, 2018. Data were collected on location of swelling, treatment setting, and medical and procedural interventions. Cases were categorized by modified Ishoo criteria, defined as follows: 1, lips, face, periorbital, extremities, total body/diffuse swelling; 2, soft palate, posterior pharynx; 3, tongue; 4, larynx. Predictive probability of disposition by stage was then compared. Results: A total of 320 patients were included in this study (median age, 44 years; 54.4% female). Stage 4 was more likely to require intensive care unit care without (probability 17%) and with (67%) airway intervention compared with stage 1 without (2.5%) and with (0.1%) airway intervention. Conversely, stage 1 was more likely to be treated in ED and discharged (85%) compared with stage 4 (0%). Stage 4 was also more likely to require airway intervention (67%) compared with other stages (1, 0.1%; 2, 8.6%; 3, 16%). Conclusion: Higher-stage patients were more likely to require higher levels of care and airway intervention. Thus, the staging system appears to be a valid method of predicting risk among ED angioedema patients.

General & Internal Medicine

Life Sciences & Biomedicine

Medicine, General & Internal

Science & Technology

Details

Title: Subtitle: Evaluation of staging criteria for disposition and airway intervention in emergency department angioedema patients
Creators: Conor Dass - University of Nebraska Medical Center
Maggie Mahaffa - University at Buffalo, State University of New York
Elizabeth Dang - University of Iowa
Ronna Campbell - Mayo Clinic
Zuhair Ballas - University of Iowa
Sangil Lee - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Acute medicine & surgery, Vol.8(1), pp.e704-n/a
DOI: 10.1002/ams2.704
PMID: 34729186
PMCID: PMC8548721
NLM abbreviation: Acute Med Surg
ISSN: 2052-8817
eISSN: 2052-8817
Publisher: Wiley
Number of pages: 6
Grant note: Department of Emergency Medicine at the University of Iowa Carver College of Medicine
Language: English
Date published: 01/01/2021
Academic Unit: Emergency Medicine; Injury Prevention Research Center; Immunology; Internal Medicine
Record Identifier: 9984297354802771

Metrics

69 Record Views

4 Times Cited - Web of Science