Clinical features of patients with acute epiglottitis in the emergency department

Abstract

Background: Acute epiglottitis is a potentially life-threatening condition, but its clinical manifestations are usually nonspecific. Objectives: We investigated the clinical differences between patients with and those without acute epiglottitis and identified the risk factors of patients with acute epiglottitis who may develop airway compromise. Methods: We studied patients suspected of having acute epiglottitis in the emergency department. All patients received fibre-optic laryngoscopy performed by an otorhinolaryngologist and were subsequently divided into two groups: patients with acute epiglottitis and those without. Results: Of the 311 adult patients, 108 were diagnosed with acute epiglottitis. In the nonepiglottitis group, more complaints of fever (p < 0.001), cough (p < 0.001), and rhinorrhoea (p = 0.048) and more systemic comorbidities were reported. People with acute epiglottitis generally had a higher prevalence of head and neck tumours (p = 0.015), odynophagia (p = 0.037) and an elevated white blood cell level (p < 0.001). The proportion of patients with cardiovascular disease (p = 0.014) or diabetes mellitus (p = 0.019), drooling (p = 0.026) or sore throat (p = 0.042), a high respiratory rate (p = 0.009), an elevated white blood cell level (p = 0.002) and a higher C-reactive protein level (p = 0.005) was higher among those who required airway intervention. Conclusion: Clinical manifestations alone were insufficiently reliable for diagnosing acute epiglottitis but could predict disease severity. Laryngoscopy should be performed as soon as possible once a patient is suspected of having acute epiglottitis.