Adult supraglottitis: changing trends

• Published in: European archives of oto-rhino-laryngology 2015-04, Vol.272 (4), p.929-935
• Main Authors: Ovnat Tamir, Sharon, Marom, Tal, Barbalat, Irina, Spevak, Stanislav, Goldfarb, Abraham, Roth, Yehudah
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Airway Obstruction - epidemiology; Airway Obstruction - etiology; Airway Obstruction - therapy; Cohort Studies; Comorbidity; Deglutition Disorders - etiology; Demography; Female; Head and Neck Surgery; Humans; Intubation, Intratracheal - methods; Intubation, Intratracheal - statistics & numerical data; Israel - epidemiology; Laryngology; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Otorhinolaryngology; Outcome Assessment (Health Care); Pharyngitis - etiology; Retrospective Studies; Risk Factors; Severity of Illness Index; Supraglottitis - diagnosis; Supraglottitis - epidemiology; Supraglottitis - physiopathology; Supraglottitis - therapy
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-014-3464-x

There is no clinical dynamic staging system which scores according to severity all the anatomical regions in adult supraglottitis. The objective of the study was to describe the demographics, clinical presentation, interventions and outcomes of adult patients diagnosed with acute supraglottitis (AS), and to study the correlation of a new AS classification with the need for airway intervention, in comparison with the current classification. This was a retrospective, cohort study conducted at a secondary medical care center. Adults diagnosed with AS from the years 1990–2013 were identified. Data were extracted for demographic and clinical information and there was no intervention. The main outcome and measures were the need for airway intervention. 288 eligible patients were enrolled. AS incidence rate was 4.3/100,000 patients/year. The mean age was 50 ± 16 years. Sore throat (94 %) and dysphagia (88 %) were the most common presenting symptoms. Patients were hospitalized either in the Otolaryngology Department ( n  = 255, 89 %) or in the Intensive Care Unit ( n  = 33, 11 %). Of the latter, 19 (58 %) had an airway securing intervention procedure. Our suggested classification was more sensitive than the current one for predicting the need for intubation ( p  = 0.03). Signs and symptoms of AS in adults are different from those in children. Adult patients presenting with oropharyngeal complaints should be suspected for AS and treated appropriately.