TY - JOUR
T1 - Age differences in inducible laryngeal obstruction in adult populations
AU - Luedders, Jennilee
AU - May, Sara
AU - Lyden, Elizabeth
AU - Rorie, Andrew
AU - Graaff, Joel Van De
AU - Zamora-Sifuentes, José
AU - Walenz, Rhonda
AU - Poole, Jill A.
N1 - Publisher Copyright:
© 2024
PY - 2024/11
Y1 - 2024/11
N2 - Background: Whereas differences in inducible laryngeal obstruction (ILO) presentation on the basis of age have been observed within pediatric populations, age-based differences in adult populations are lacking. Objective: To describe differences in ILO on the basis of age in adults. Methods: Patients aged older than 16 years with confirmed ILO (vocal cord adduction > 50% during inspiration) by means of provocation-challenge rhinolaryngoscopy by their treating allergist were included. An investigator-designed questionnaire was administered using Research Electronic Data Capture with corresponding medical data collection. χ2 tests, Student's t tests, analysis of variance, Cochran-Armitage test for trend, and Fisher's exact test were used. Results: The median age of the 67 patients was 50 years. P values less than .05 were considered significant. Those aged younger than 50 years (n = 31; mean age 35.6 years) reported more symptoms vs age 50 years and older (n = 36; mean age 61.8 years), including shortness of breath at rest and exertion (84% vs 39%, 94% vs 72%), throat tightness (81% vs 50%), chest tightness (81% vs 47%), and difficulty getting air in (81% vs 56%). Those aged younger than 50 years had an increased history of anxiety (68% vs 33%), asthma (55% vs 31%), positive methacholine challenge (52% vs 22%), increasing triggers with time (87% vs 43%), higher Pittsburgh Vocal Cord Dysfunction Index Scores (6.9 vs 5.5), and inspiratory curve flattening (48% vs 24%). Additional age-based subdivisions confirmed significant trends with the lowest reported ILO characteristics and symptoms in those aged 65 years and older. Conclusion: A high index of suspicion for ILO should be maintained in older adults since they may report less typical ILO symptoms and anxiety associations that prompt ILO evaluation.
AB - Background: Whereas differences in inducible laryngeal obstruction (ILO) presentation on the basis of age have been observed within pediatric populations, age-based differences in adult populations are lacking. Objective: To describe differences in ILO on the basis of age in adults. Methods: Patients aged older than 16 years with confirmed ILO (vocal cord adduction > 50% during inspiration) by means of provocation-challenge rhinolaryngoscopy by their treating allergist were included. An investigator-designed questionnaire was administered using Research Electronic Data Capture with corresponding medical data collection. χ2 tests, Student's t tests, analysis of variance, Cochran-Armitage test for trend, and Fisher's exact test were used. Results: The median age of the 67 patients was 50 years. P values less than .05 were considered significant. Those aged younger than 50 years (n = 31; mean age 35.6 years) reported more symptoms vs age 50 years and older (n = 36; mean age 61.8 years), including shortness of breath at rest and exertion (84% vs 39%, 94% vs 72%), throat tightness (81% vs 50%), chest tightness (81% vs 47%), and difficulty getting air in (81% vs 56%). Those aged younger than 50 years had an increased history of anxiety (68% vs 33%), asthma (55% vs 31%), positive methacholine challenge (52% vs 22%), increasing triggers with time (87% vs 43%), higher Pittsburgh Vocal Cord Dysfunction Index Scores (6.9 vs 5.5), and inspiratory curve flattening (48% vs 24%). Additional age-based subdivisions confirmed significant trends with the lowest reported ILO characteristics and symptoms in those aged 65 years and older. Conclusion: A high index of suspicion for ILO should be maintained in older adults since they may report less typical ILO symptoms and anxiety associations that prompt ILO evaluation.
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U2 - 10.1016/j.anai.2024.08.005
DO - 10.1016/j.anai.2024.08.005
M3 - Article
C2 - 39154909
AN - SCOPUS:85202966712
SN - 1081-1206
VL - 133
SP - 574
EP - 580
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 5
ER -