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Factors associated with severe epiglottitis in adults: Analysis of a J apanese inpatient database
Author(s) -
Suzuki Sayaka,
Yasunaga Hideo,
Matsui Hiroki,
Fushimi Kiyohide,
Yamasoba Tatsuya
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25114
Subject(s) - medicine , epiglottitis , odds ratio , confidence interval , logistic regression , retrospective cohort study , body mass index , pediatrics , cohort study
Objectives/Hypothesis The aim of the study was to evaluate the factors associated with the development of severe epiglottitis in adults to provide information for physicians to make early decisions on airway management. Study Design Retrospective cohort study. Methods Adult patients admitted to acute care hospitals with a diagnosis of acute epiglottitis between January 2011 and December 2012 were identified in the Diagnosis Procedure Combination database of Japan. The main outcome measures were: 1) severe epiglottitis requiring airway intervention or resulting in early death within 2 days after admission and 2) 2‐day mortality. Multivariable logistic regression analysis was performed to evaluate the association between patient characteristics and development of severe epiglottitis. Results A total of 6,072 epiglottitis patients from 599 hospitals were identified. The proportion of developing severe epiglottitis was 9.4%, and 2‐day mortality was 0.4%. Factors significantly associated with severe epiglottitis were older age, male sex (adjusted odds ratio [OR] 1.60; 95% confidence interval [CI], 1.28–2.00; P < .001), body mass index (BMI) >25.0 kg/m 2 (OR 1.31; 95% CI, 1.05–1.63; P = .018), diabetes mellitus (OR 1.41; 95% CI, 1.06–1.86; P = .017), epiglottic cyst (OR 2.90; 95% CI, 1.46–5.78; P = .002), pneumonia (OR 2.90; 95% CI, 1.73–4.86; P < .001), and academic hospitals (OR 1.56; 95% CI, 1.21–2.00; P = .001). Epiglottitis‐related admission was summer‐dominant, but seasonality was not significantly associated with severe epiglottitis. Conclusion Development of severe epiglottitis was significantly associated with older age, BMI >25.0 kg/m 2 , diabetes mellitus, epiglottic cyst, or pneumonia at admission. Level of Evidence 2b. Laryngoscope , 125:2072–2078, 2015