Evidence map›Paper›PMID 29721614›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2018

A score for the differential diagnosis of bradykinin- and histamine-induced head and neck swellings.

M Lenschow, M Bas, F Johnson, M Wirth, U Strassen

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. [Emergency management of angioedema].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021
    Article
  2. Evaluation and Management of Angioedema in the Emergency Department.The western journal of emergency medicine · 2019
    Review
  3. Isolated angioedema: An overview of clinical features and etiology.Experimental and therapeutic medicine · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

M LenschowDepartment of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, Munich, Germany.
M BasDepartment of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, Munich, Germany.
F JohnsonDepartment of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, Munich, Germany.
M WirthDepartment of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, Munich, Germany.
U StrassenDepartment of Otorhinolaryngology, Head and Neck Surgery, Technical University of Munich, Munich, Germany. u.strassen@lrz.tum.de.ORCID http://orcid.org/0000-0002-3366-2137
Technical University of Munich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAcute edema of the head and neck region may lead to life-threatening dyspnea and require quick and targeted treatment. They can be subdivided in bradykinin- and histamine-mediated swellings, which require treatment with different classes of pharmaceuticals. Clinical pathways for differential diagnoses do not exist so far, although it is known that early treatment is decisive for faster symptom relief and reduced expression of the swellings. Aim of the study was the creation of a clinical algorithm for identification of bradykinin-mediated angioedema.

methods188 patients that presented to our outpatient department between 2010 and 2016 with an acute, non-inflammatory swelling of the head and neck region were included in our retrospective study. All available anamnestic and clinical parameters were obtained from patient files. Parameters showing significant differences between the two groups were included in our score. Utilization of the Youden's index allowed determination of an optimal cut-off value.

results76 patients could be assigned to the histamine and 112 patients to bradykinin group. The following parameters were included in our score: age, dyspnea, itching or erythema, glucocorticoid response and intake of ACEi/AT-II blockers. The cut-off value is set at three points. The proposed score yielded a sensitivity for identification of bradykinin-mediated angioedema of 96%, a specificity of 84%, a positive predictive value of 91% and a negative predictive value of 93%.

conclusionsUtilization of the proposed score allows quick and reliable assignment of patients to the correct subgroup and thereby reduces time for treatment.

Indexed as

BradykininHeadHistamineNeckAdultAgedAged, 80 and overAngioedemaDiagnosis, DifferentialFemaleGlucocorticoidsHumansMaleMiddle AgedRetrospective StudiesYoung AdultBradykininGlucocorticoidsHistamineACE inhibitorAngioedemaBradykininDifferential diagnosisHistamineUrticarial

Identifiers

PMID29721614
OpenAlexW2802334861

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.