HSC Section 3 - Trauma, Critical Care and Sleep Medicine

RESULTS After reviewing 820 medical records, 62 patients met the inclusion criteria. Thirty-six patients were identi fi ed in the pre-DART, and 27 were in the post-DART cohort. The study fl owchart describing allocation of patients into their respective cohorts are described in Figure 2. Patient Characteristics The mean age of patients was 54 years in the pre- DART cohort and 50 years in the post-DART. There was no statistical difference in the age, sex, and location of air- way call between the pre-DART and post-DART cohorts. There were similar numbers of women and men in the pre- DART cohort, whereas there were more women in the post-DART cohort (Table I). The majority of patients in the pre-DART and post-DART cohort (78% and 56%, respec- tively) were encountered with angioedema in the emer- gency department. Among the pre-DART cohort, the most common etiology of angioedema was ACE-I (58.3%), followed by hereditary (19.4%) and idiopathic (11.1%) causes. The most common etiology of angioedema in the post-DART cohort was medications such as penicillin, sulfamethoxazole and trimethoprim, and metoclopramide (33.3%) — followed by idiopathic (29.6%) and ACE-I (25.9%). The etiology of angioedema was signi fi cantly different between pre-DART and post-DART cohorts ( P = 0.003) (Table I).

Statistical Analysis Stata InterCooled 14.2 (StataCorp LP, College Station, TX) was used to analyze the data. 18 Descriptive statistics such as mean and standard deviations were calculated for parametric data, whereas frequencies and percentages were calculated for categorical data. Comparative statistics included t tests parametric data and chi square or Fisher exact tests for categorical variables, depending on the cell size. Backward stepwise logistic regression analyses were used to identify the predictors of airway intervention. Fig. 2. Flowchart of angioedema cases identi fi ed and categorized into three cohorts. DART = dif fi cult airway response team; OHN = otolaryngology – head and neck surgeons.

TABLE I. Patient Characteristics.

Pre-DART

Post-DART

Characteristics

n = 36

n = 27

P Value

Age Sex

54.5 13.9

49.9 15.0

0.21 0.07

Women

17 (47.2) 19 (52.8)

19 (70.4) 8 (29.6) 5 (18.5) 15 (55.6) 7 (25.9) 7 (25.9) 9 (33.3)

Men

Location of airway call

Floor

3 (8.3)

0.21

Emergency department

28 (77.8)

Intensive care unit

5 (13.9)

Etiology

Angiotensin converting enzyme inhibitor

21 (58.3)

0.003

Other medications

3 (8.3)

Hereditary

7 (19.4) 4 (11.1)

1 (3.7)

Idiopathic

8 (29.6)

Food

1 (2.8)

2 (7.4)

Number of anatomical sites involved

1 2 3 4

19 (52.8) 16 (44.4)

17 (63.0)

0.42

9 (33.3)

1 (2.8)

0

0

1 (3.7)

Site involvement

Lips

12 (33.3) 10 (27.8)

13 (48.1) 13 (48.1)

0.23 0.10 0.10 0.12 0.71 0.73 0.06

Anterior tongue

Floor of the mouth

4 (11.1)

0 0

Soft palate

3 (8.3) 3 (8.3)

Base of the tongue

3 (11.1) 7 (25.9) 4 (14.8)

Larynx

8 (22.2)

Pharynx

13 (36.1)

All data presented in frequencies (percentages), except for variable age, which is presented as mean standard deviation. DART = dif fi cult airway response team.

Laryngoscope 129: June 2019

Pandian et al.: Dif fi cult Airway

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