Adult acute epiglottitis: Experiences in a Taiwanese setting
Presented at the 7th Japan-Taiwan Conference in Otolaryngology-Head and Neck Surgery, Tokyo, Japan, October 29-31, 2003.
Objective
Acute epiglottitis is a potentially disastrous disease seen occasionally in otolaryngology emergency service. This study reports our experiences in managing adult patients with acute epiglottitis in a Taiwanese setting.
Study design
Admission medical records from 46 adult patients with acute epiglottitis over a period of 8 years in a tertiary referral otolaryngology service were retrospectively reviewed.
Results
No mortality was reported; 4 (8.7%) patients were supported by artificial airway. A total of 16 (34.8%) patients had comorbid conditions; hypertension and diabetes mellitus were the most common systemic diseases. Patients who needed artificial airway support tended to have more systemic comorbidities (P = 0.001) and a higher level of hyperglycemia (P = 0.004) than those who did not need airway support. The incidences of drooling, stridor/dyspnea, and muffled voice were significantly higher in the airway-supported group (P < 0.05). Stridor/dyspnea is a reliable clinical predictor of airway compromise (odds ratio 2.94; P = 0.0277).
Conclusion
Dyspnea is a warning sign of impending airway collapse during an episode of acute epiglottitis. Adult patients with more systemic comorbidities might bear higher risk of airway compromise; the role of diabetes mellitus can’t be overlooked.
aDepartment of Otolaryngology, Cathay General Hospital, Taipei
bFu Jen Catholic University School of Medicine, College of Public Health, China Medical University, Taichung
bDepartment of Public Health, College of Public Health, China Medical University, Taichung
dInstitute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.
Reprint requests: Pa-Chun Wang, MD, MSc, Department of Otolaryngology, Cathay General Hospital, 280 Sec.4 Jen-Ai Road, 106, Taipei, Taiwan
ABSTRACT