Abstract
PurposeIn acute epiglottitis (AE) or acute supraglottitis (AS), the management of the airway is crucial. We hypothesized that tracheotomized patients recover faster than intubated patients do.MethodsWe retrospectively reviewed all adult AE and AS patients, who underwent intubation or tracheotomy between 2007 and 2018 in a tertiary care center. Patient demographics, treatment, and complications were analyzed.ResultsThe cohort comprised 42 patients. The airway was secured with intubation in 50% and with tracheotomy in 50%. All intubated patients (n = 21) and three tracheotomized patients were treated in the intensive care unit (p < 0.0001). Procedure-related complications were encountered in three intubated and eight tracheotomized patients (p = 0.892). Median overall treatment cost was 11.547 € and 5.856 € in the intubated and tracheotomized patient groups, respectively (p < 0.001). The median duration of sick leave after discharge from hospital was 13 days in the tracheotomy group and 7 days in the intubation group (p = 0.097).ConclusionTracheotomy resulted in a less expensive management in securing the airway in AE or AS, but tracheotomized patients had a trend towards more complications and longer sick leaves compared to intubated patients.Level of evidence2b
Highlights
Acute epiglottitis (AE), or supraglottitis (AS), is a potentially life-threating condition, in which the inflammation and edema of the epiglottis and/or adjacent supraglottic structures may endanger the airway within hours [1]
The airway was secured with either intubation or tracheotomy in 63 adult patients with AE or acute supraglottitis (AS)
42 patients (27 AE, 15 AS) formed the study cohort, and we divided them into two subgroups based on airway management
Summary
Acute epiglottitis (AE), or supraglottitis (AS), is a potentially life-threating condition, in which the inflammation and edema of the epiglottis and/or adjacent supraglottic structures may endanger the airway within hours [1]. In the post Hemofilus influenzae type b vaccine era, there has been a shift in AE and AS from the stereotypical children’s disease towards affecting the adult population [2, 3]. In Finland the incidence of AS in adults has increased from 1.88 in the 1990sss to 4.73 in the twenty-first century per 100,000 inhabitants [4]. The presence of stridor, tachypnea, hypoxia, Materials and methods. This retrospective study was conducted in the Helsinki University Hospital, Helsinki, Finland with a referral area of 1.6 million people. Patient data between May 1, 2007 and November 30, 2018 were retrieved from the electronic operative files. We included all adult (18 years and older) patients who were treated at the operative theatre at the Helsinki University Hospital with the diagnosis code (ICD-10) of
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