title: Acute supraglottitis in adults in Finland: review and analysis of 308 cases.
abstract: OBJECTIVE
  The aim of this article is to study the clinical features, management, and outcome in adult patients with acute supraglottitis.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  We searched the medical records from our database from the years 1989 to 2009 using codes of international statistical classification of diseases and related health problems for acute epiglottitis or supraglottitis. In total, 308 patients were identified.
  
  
  RESULTS
  Incidence of acute supraglottitis increased from 1.88 (first decade) to 4.73 per 100,000 cases (second decade) (P = .05). The mean age of the patients was 49 years old with a slightly male predominance. Sore throat and odynophagia were the most common symptoms. Concomitant disease were common among the patients. Isolated inflammation of epiglottis without involvement of other supraglottic tissue was detected only in 51 patients. Intravenous cephalosporins were the most common empiric antibiotic treatment regimen. Intravenous corticosteroids were administered to half of the cases. Streptococcus was the most common organism in throat cultures. In total, 45 patients needed airway intervention. Complications were rare and mortality was 0.6% in our series.
  
  
  CONCLUSIONS
  Acute supraglottitis in adults seems to be a different entity than epiglottitis in children, and inflammation does not usually exclusively involve the epiglottis. Early diagnosis seems to decrease the need for airway intervention and to permit the successful treatment of the patient with intravenous antibiotics and corticosteroids. Streptococcus appears as the dominant causative microorganism. However systemic diseases and other local infections that compromise the regional supraglottic immunity may increase the risk for acute supraglottitis.
authors: Department of Otorhinolaryngology, Tampere University and Tampere University Hospital, Tampere, Finland. arbizaki@gmail.com
authors: Argyro J
authors: AJ
authors: Bizaki
authors: Jura
authors: J
authors: Numminen
authors: Jussi-Pekka
authors: JP
authors: Vasama
authors: Jussi
authors: J
authors: Laranne
authors: Markus
authors: M
authors: Rautiainen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D004826:Epiglottitis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents