{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T05:15:04Z","timestamp":1734066904363,"version":"3.30.2"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Individuals with angioedema (AE) are at high risk for airway compromise and often require endotracheal intubation. Patient factors predisposing one to airway compromise are not well described. The objective of this study is to examine whether substance use disorder (SUD) in patients with AE is associated with need for airway intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based retrospective cohort study compared AE patients with SUD versus propensity\u2010matched control groups. Outcomes were hospitalization, intubation, and tracheotomy. Using the TriNetX National Database, this study included 28,931 patients with SUD and 117,509 patients without SUD who presented with AE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among patients with AE, those with each subtype of SUD (alcohol, cannabis, cocaine, tobacco, and opioids) were found to have higher risk of severe AE compared to propensity\u2010matched non\u2010SUD cohorts. Rate of hospitalization after cohort matching ranged from 20.4% for tobacco use disorder to 30.4% for cocaine use disorder, all significantly higher than the 8.0% in a population without SUD. Each SUD subtype was associated with a higher rate of intubation compared with matched non\u2010SUD groups, with cannabis use disorder having the highest relative risk (RR) of 3.67 (95% CI: 2.69\u20135.02). Tobacco (RR\u2009=\u20092.45, 95% CI: 1.79\u20133.34) and alcohol (RR\u2009=\u20092.82, 95% CI: 1.73\u20134.58) use disorders were both associated with significantly higher risk of tracheotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data suggest that patients with SUD, regardless of subtype, and after propensity matching for demographics and comorbidities are at higher risk for adverse outcomes when presenting with AE. This study highlights clinically relevant predictors of airway compromise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level 3 <jats:italic>Laryngoscope<\/jats:italic>, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31644","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T10:59:34Z","timestamp":1721041174000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Substance Use Disorder as Risk Factor for Intubation in Angioedema: A Nationwide Cohort Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6977-044X","authenticated-orcid":false,"given":"Joseph","family":"Bogart","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University Hospitals Cleveland Medical Center  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd","family":"Otteson","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University Hospitals Cleveland Medical Center  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jaip.2013.07.005","article-title":"ACE inhibitor\u2010induced angioedema","volume":"1","author":"Baram M","year":"2013","journal-title":"J Allergy Clin Immunol Pract"},{"key":"e_1_2_6_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.intimp.2019.106081","article-title":"ACE inhibitor\u2010mediated angioedema","volume":"78","author":"Montinaro V","year":"2020","journal-title":"Int 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