A systematic review and meta‐analysis of predictors of airway intervention in adult epiglottitis

Objective Epiglottitis is typically considered a pediatric disease; however, there is growing evidence that the incidence of adult epiglottitis has changed since the introduction of the Haemophilus influenzae vaccine. The literature is composed of multiple small series with differing findings. To da...

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Bibliographic Details
Published in:The Laryngoscope 2020-02, Vol.130 (2), p.465-473
Main Authors: Sideris, Anders, Holmes, Timothy R., Cumming, Benjamin, Havas, Thomas
Format: Article
Language:English
Subjects:
Adult
Adult epiglottitis
airway intervention
Airway management
Airway Management - methods
Bacterial infections
epiglottic abscess
epiglottitis
Epiglottitis - prevention & control
Epiglottitis - therapy
Epiglottitis - virology
Haemophilus Vaccines
Humans
Inflammation
Intubation
Meta-analysis
microbiology
Throat
tracheostomy
Vaccines
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Summary:Objective Epiglottitis is typically considered a pediatric disease; however, there is growing evidence that the incidence of adult epiglottitis has changed since the introduction of the Haemophilus influenzae vaccine. The literature is composed of multiple small series with differing findings. To date, there has been no attempt to collaborate evidence on predictors of airway intervention in this disease. Methods The population of interest was adults with a diagnosis of epiglottitis. The primary outcome in this review was incidence of airway intervention. A comprehensive literature search was conducted of the MEDLINE and Embase databases, and a separate random‐effects model meta‐analysis was undertaken for all outcome data. Moderator tests for comparison between prevaccine and postvaccine estimates were made, and absolute risk difference (RD) and relative risk (RR) calculations were made for all predictors of airway intervention. Results Thirty studies and a total of 10,148 patients were finally included for meta‐analysis. A significant decrease in airway intervention was seen post vaccine introduction introduction from 18.8% to 10.9% (P = 0.01). The presence of an abscess (RD 0.27, P = 0.04; RR 2.45, P 
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.28076