Airway obstruction in hemophilia (factor VIII deficiency): a 28-year institutional review.
Life-threatening airway compromise is rarely reported as a major complication of coagulation disorders. However, before adequate factor-replacement therapy became available, this complication was often fatal. A retrospective review of all patients with classic hemophilia admitted to our institution from 1964 through 1992 was performed. The records of 147 patients who had a total of 1804 admissions were examined. Fifteen episodes of airway obstruction occurred. Additionally, 6 cases of potential airway compromise and 5 cases of airway-endangering oropharyngeal bleeding were identified. Tracheotomy was performed in 5 patients; 1 fatality occurred before modern replacement products were available. Patients with this disorder have a 13% chance of some form of airway-endangering event with an 8% chance that it will be immediately life-threatening. Tracheotomy and subsequent decannulation are safe procedures in these patients.
Department of Otolaryngology-Head and Neck Surgery, University Hospital of Cleveland, Ohio 44106.
C J
CJ
Bogdan
M
M
Strauss
O D
OD
Ratnoff
D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005169:Factor VIII / Q000627:therapeutic use; D005260:Female; D006467:Hemophilia A / Q000150:complications*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014140:Tracheotomy
D005169:Factor VIII