Adult Acute Epiglottitis: Predictors for Airway Intervention and Intensive Care Unit Admission

Lam, Pui Kin; Choi, Yufai; Wong, Tai Wai; Lau, Chor Chiu

doi:10.1177/102490790901600402

Cited by 2 publications

(2 citation statements)

References 45 publications

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“…The lack of specific symptoms in adult has resulted in 12.6% of misdiagnosis at the initial ED visits. 2 An ideal emergency department diagnostic test of acute epiglottitis should be simple, rapid, noninvasive, highly accurate and easily performed at the bedside by emergency physicians (EP). Flexible endoscopy is a good test but it is invasive and requires more skill.…”

Section: Introductionmentioning

confidence: 99%

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Sonographic Measurement of the Epiglottis in Normal Chinese Adults

Chau¹,

Chan²,

Wong³

et al. 2010

Hong Kong Journal of Emergency Medicine

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Objectives: (1) To assess the normal range of thickness of the epiglottis by means of ultrasound measurement. (2) To evaluate inter-observer agreement in measuring the thickness of the epiglottis of normal individuals by ultrasound. (3) To assess the association between biological factors and the thickness of the epiglottis. Methods: Fifty adult volunteers working at a local accident and emergency department were recruited. The thickness of the epiglottis was measured by means of ultrasound examination, which was performed twice by two emergency physicians at different time. The study subjects' age, sex, height and body weight were recorded. Results: The mean thickness of the epiglottis was 0.236 cm and the standard deviation was 0.020. Male subjects had thicker epiglottis. Interobserver agreement of the two emergency physicians who performed the ultrasound scan was very good. Multiple regression models showed that sex and height were useful predictors of the thickness of the epiglottis. Conclusions: Bedside ultrasound assessment of the epiglottis is an easy, rapid and reliable method to evaluate its thickness. Further studies are needed to evaluate the thickness of the epiglottis in patients with epiglottitis before it can be put into clinical use.

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Section: Introductionmentioning

confidence: 99%

“…However, its overall sensitivity in detecting epiglottitis is only about 89.4%. 2 Ultrasonography of the epiglottis may prove particularly useful in those unstable patients who should not be sent to the radiology department.…”

Section: Introductionmentioning

confidence: 99%

Sonographic Measurement of the Epiglottis in Normal Chinese Adults

Chau¹,

Chan²,

Wong³

et al. 2010

Hong Kong Journal of Emergency Medicine

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

et al. 2019

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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 < 0.001), stridor (RD 0.64, P < 0.001; RR 7.15, P < 0.001), or a history of diabetes mellitus (RD 0.11, P = 0.02; RR 2.15, P = 0.01) were associated with need for airway intervention. Conclusion In the postvaccine era, clinicians should expect to have to secure airways in 10.9% of cases. The presence of an epiglottic abscess, stridor, or a history of diabetes mellitus are the most reliable clinical features associated with need for airway intervention. Level of Evidence NA Laryngoscope, 130:465–473, 2020

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Adult Acute Epiglottitis: Predictors for Airway Intervention and Intensive Care Unit Admission

Cited by 2 publications

References 45 publications

Sonographic Measurement of the Epiglottis in Normal Chinese Adults

Sonographic Measurement of the Epiglottis in Normal Chinese Adults

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

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