Supraglottitis in adult population - Risk factors for complications and prolonged hospitalization

Authors

  • Pedro Alexandre Centro Hospitalar Universitário de São João, Porto; Unidade de Otorrinolaringologia, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Sónia Pires Martins Centro Hospitalar Universitário de São João, Porto; Unidade de Otorrinolaringologia, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Carla Pinto Moura Centro Hospitalar Universitário de São João, Porto; Serviço de Genética, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto; Instituto de Investigação e Inovação em Saúde, i3S, Universidade do Porto, Portugal
  • Margarida Santos Centro Hospitalar Universitário de São João, Porto, Portugal

DOI:

https://doi.org/10.34631/sporl.849

Keywords:

supraglottitis, epiglottitis, risk factors, complications, hospitalization time

Abstract

Objectives: To characterize supraglottitis in adult patients, identifying risk factors for complications and prolonged hospitalization 

Material and Methods: Retrospective cohort study that adult patients admitted with acute supraglottitis/epiglottitis, between 2013 and 2019. 

Results: This study included 70 patients. Three of them complicated with epiglottis abscess. Two cases of upper airway obstruction were registered needing invasive procedures. The presence of suppuration was associated with the development of complications. Neutrophil relative count and blood glucose at admission, and the presence of arterial hypertension, were related with a prolonged hospital stay. 

Conclusions: Supraglottitis can progress to serious complications. The presence of pus, high relative neutrophil count and the presence of comorbidities such as high blood pressure and decompensated diabetes mellitus with high blood glucose at admission have shown to be risk factors to be considered during supraglottitis evaluation, vigilance and therapeutic options. 

References

- Frantz TD, Rasgon BM. Acute epiglottitis: changing epidemiologic patterns. Otolaryngol Head Neck Surg. 1993 Sep;109(3 Pt 1):457-60. doi: 10.1177/019459989310900311.

- Flint PW, Haughey BH, Lund VJ, Niparko JK, et al. Cummings Otolaryngology Head and Neck Surgery. Philadelphia: Elsevier; 2015.

- Shah RK, Roberson DW, Jones DT. Epiglottitis in the Hemophilus influenzae type B vaccine era: changing trends. Laryngoscope. 2004 Mar;114(3):557-60. doi: 10.1097/00005537-200403000-00031.

- Mayo-Smith M, Spinale J, Donskey C, Yukawa M, Li R, Schiffman F. Acute epiglottitis: An 18-year experience in Rhode Island. Chest. 1995 Dec;108(6):1640-7. doi: 10.1378/chest.108.6.1640.

- Berger G, Landau T, Berger S, Finkelstein Y. et al. Rising incidence of adult acute epiglottitis and epiglottic abscess. Am J Otolaryngol. Nov-Dec 2003;24(6):374-83. doi: 10.1016/s0196-0709(03)00083-8.

- Wong EY Y, Berkowitz RG. Acute epiglottitis in adults: the Royal Melbourne Hospital experience. ANZ J Surg. 2001 Dec;71(12):740-3. doi: 10.1046/j.1445-1433.2001.02265.x.

- Guardiani E, Bliss M, Harley E. Supraglottitis in the Era Following Widespread Immunization Against Haemophilus influenzae Type B: Evolving Principles in Diagnosis and Management. Laryngoscope. 2010 Nov;120(11):2183-8. doi: 10.1002/lary.21083.

- Shapira Galitz Y, Shoffel-Havakuk H, Cohen O, Halperin D, Lahav Y. Adult Acute Supraglottitis: Analysis of 358 Patients for Predictors of Airway Intervention. Laryngoscope. 2017 Sep;127(9):2106-2112. doi: 10.1002/lary.26609.

- Kent S, Hennedige A, McDonald C, Henry A. et al. Systematic review of the role of corticosteroids in cervicofacial infections. Br J Oral Maxillofac Surg. 2019 Apr;57(3):196-206. doi: 10.1016/j.bjoms.2019.01.010.

- Riffat F, Jefferson N, Bari N, McGuinness J. Acute Supraglottitis in Adults. Ann Otol Rhinol Laryngol. 2011 May;120(5):296-9. doi: 10.1177/000348941112000503.

- Gillet D, Eynon-Lewis NJ. Supraglottitis and abscess formation. J Laryngol Otol. 2011 Jan;125(1):99-102. doi: 10.1017/S0022215110001611.

– Bjornson C, Russel K, Vandermeer B, Klassen TP. et al. Nebulized Epinephrine for Croup in Children. Cochrane Database Syst Rev. 2013 Oct 10;(10):CD006619. doi: 10.1002/14651858.CD006619.pub3.

- Ringel B, Shilo S, Carmel-Neiderman NN, Livneh N. et al. Low rates of airway intervention in adult supraglottitis: A case series and meta-analysis. Am J Otolaryngol. 2020 Apr 4;102482. doi: 10.1016/j.amjoto.2020.102482.

Published

2020-12-05

How to Cite

Alexandre, P., Martins, S. P., Moura, C. P., & Santos, M. (2020). Supraglottitis in adult population - Risk factors for complications and prolonged hospitalization. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 58(4), 227–231. https://doi.org/10.34631/sporl.849

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Section

Original Article