title: Adult acute epiglottitis: experiences in a Taiwanese setting.
abstract: OBJECTIVE
  Acute epiglottitis is a potentially disastrous disease seen occasionally in otolaryngology emergency service. This study reports our experiences in managing adult patients with acute epiglottitis in a Taiwanese setting.
  
  
  METHODS
  Admission medical records from 46 adult patients with acute epiglottitis over a period of 8 years in a tertiary referral otolaryngology service were retrospectively reviewed.
  
  
  RESULTS
  No mortality was reported; 4 (8.7%) patients were supported by artificial airway. A total of 16 (34.8%) patients had comorbid conditions; hypertension and diabetes mellitus were the most common systemic diseases. Patients who needed artificial airway support tended to have more systemic comorbidities ( P = 0.001) and a higher level of hyperglycemia ( P = 0.004) than those who did not need airway support. The incidences of drooling, stridor/dyspnea, and muffled voice were significantly higher in the airway-supported group ( P < 0.05). Stridor/dyspnea is a reliable clinical predictor of airway compromise (odds ratio 2.94; P = 0.0277).
  
  
  CONCLUSIONS
  Dyspnea is a warning sign of impending airway collapse during an episode of acute epiglottitis. Adult patients with more systemic comorbidities might bear higher risk of airway compromise; the role of diabetes mellitus can't be overlooked.
authors.affiliation: Department of Otolaryngology, Cathay General Hospital, 280 Sec. 4 Jen-Ai Road, 106, Taipei, Taiwan.
authors.forename: Yen-Liang
authors.initials: YL
authors.lastname: Chang
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Lo
authors.forename: Pa-Chun
authors.initials: PC
authors.lastname: Wang
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Shu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004417:Dyspnea / Q000209:etiology; D004826:Epiglottitis / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D016896:Treatment Outcome