血管性水肿:是否需要住院?单一机构评估。

IF 1.7 Q4 CRITICAL CARE MEDICINE
Journal of Critical Care Medicine Pub Date : 2025-07-31 eCollection Date: 2025-07-01 DOI:10.2478/jccm-2025-0023
Madeleine Brill-Edwards, W Chase Hamilton, Erika J Yoo, Jennifer Costello, George J Koenig, Murray J Cohen, Joshua A Marks
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引用次数: 0

摘要

血管性水肿有可能导致气道快速失代偿,需要干预。患者通常被送进ICU进行“气道监护”。缺乏证据支持哪些患者需要这种治疗。目的:我们旨在描述我院血管性水肿患者的入院模式和预后,以评估资源利用和ICU使用的必要性。我们假设患者在就诊时不需要插管,在ICU外治疗是安全的。材料与方法:回顾性分析2017 - 2020年在我市学术性四级转诊机构就诊的血管性水肿ICD-10编码患者。图表回顾了人口统计学、病因学、入院地点、护理水平、住院时间(LOS)、插管信息、出院目的地和特定治疗。统计分析包括连续变量(LOS)的t检验。结果:135例血管性水肿患者中,117例住院。50人住进重症监护室。患者按性别平均分布,大多数为黑人,最常见的病因是ace抑制剂的使用。20例主要在ICU外需要插管进行气道干预,只有2例在ICU内。在急诊科进行了1例气管插管手术。从出现到插管平均时间为2.7小时(最小0小时;最大7.5小时)。非插管患者在ICU的平均生存时间为1.1天,在医院的平均生存时间为1.5天,而非住院患者的平均生存时间为0.25天(结论:大多数血管性水肿患者在出现的最初几个小时内不需要气道干预。气道失代偿和干预大多发生在ICU设置之前。ICU资源应谨慎分配,对于在初始评估时未插管的血管性水肿患者可能是不必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Angioedema: Is ICU admission warranted? A single institution assessment.

Angioedema: Is ICU admission warranted? A single institution assessment.

Angioedema: Is ICU admission warranted? A single institution assessment.

Angioedema: Is ICU admission warranted? A single institution assessment.

Introduction: Angioedema has potential for rapid airway decompensation requiring intervention. Patients are often admitted to an ICU for "airway watch." There is a lack of evidence to support which patients require this.

Aim: We aimed to characterize admission patterns and outcomes of angioedema patients at our institution to assess resource utilization and necessity of ICU use. We hypothesized that patients not requiring intubation upon presentation are safe to manage outside the ICU.

Materials and methods: Retrospective chart review of patients admitted to our urban academic quaternary referral institution with angioedema ICD-10 codes between 2017 and 2020. Charts reviewed for demographics, etiology, admission location, level of care, length of stay (LOS), intubation information, discharge destination, and specific treatment administered. Statistical analysis included a t-test for continuous variables (LOS).

Results: Of 135 encounters for angioedema, 117 patients were admitted. 50 were admitted to an ICU. Patients were evenly split based on sex, majority black, and the most common etiology was ACE-inhibitor use. 20 required airway intervention with intubations primarily outside the ICU setting and only 2 in the ICU. 1 surgical airway performed in the ED. The mean time from presentation to intubation was 2.7 hours (Min 0h; Max 7.5h). The average ICU LOS for non-intubated patients was 1.1 days, with hospital LOS 1.5 days compared to 0.25 days for those not admitted to an ICU (p<0.001). For intubated patients, average ICU LOS was 4.3 days, with hospital LOS 6.2 days. All intubated patients were successfully liberated from the ventilator. No deaths occurred.

Conclusion: Most angioedema encounters did not require airway intervention within the first hours of presentation. Airway decompensation and intervention mostly occurred prior to the ICU setting. ICU resources should be carefully allocated and may be unnecessary for patients presenting with angioedema who are not intubated on initial evaluation.

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来源期刊
Journal of Critical Care Medicine
Journal of Critical Care Medicine CRITICAL CARE MEDICINE-
CiteScore
2.00
自引率
9.10%
发文量
21
审稿时长
11 weeks
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