title: Long-term outcome of critically ill adult patients with acute epiglottitis.
abstract: BACKGROUND
  Acute epiglottitis is a potentially life threatening disease, with a growing incidence in the adult population. Its long-term outcome after Intensive Care Unit (ICU) hospitalization has rarely been studied.
  
  
  RESULTS
  Thirty-four adult patients admitted for acute epiglottitis were included in this retrospective multicentric study. The mean age was 44 ± 12 years (sex ratio: 5.8). Sixteen patients (47%) had a history of smoking while 8 (24%) had no previous medical history. The average time of disease progression before ICU was 2.6 ± 3.6 days. The main reasons for hospitalization were continuous monitoring (17 cases, 50%) and acute respiratory distress (10 cases, 29%). Microbiological documentation could be made in 9 cases (26%), with Streptococcus spp. present in 7 cases (21%). Organ failure at ICU admission occurred in 8 cases (24%). Thirteen patients (38%) required respiratory assistance during ICU stay; 9 (26%) required surgery. Two patients (6%) died following hypoxemic cardiac arrest. Five patients (15%) had sequelae at 1 year. Patients requiring respiratory assistance had a longer duration of symptoms and more frequent anti inflammatory use before ICU admission and sequelae at 1 year (p < 0.05 versus non-ventilated patients). After logistic regression analysis, only exposure to anti-inflammatory drugs before admission was independently associated with airway intervention (OR, 4.96; 95% CI, 1.06-23.16).
  
  
  CONCLUSIONS
  The profile of the cases consisted of young smoking men with little comorbidity. Streptococcus spp. infection represented the main etiology. Outcome was favorable if early respiratory tract protection could be performed in good conditions. Morbidity and sequelae were greater in patients requiring airway intervention.
authors.affiliation: Service de Réanimation Médicale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Chroboczek
authors.affiliation: Service de Réanimation Médicale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
authors.forename: Martin
authors.initials: M
authors.lastname: Cour
authors.affiliation: Service de Réanimation Médicale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Hernu
authors.affiliation: Service de Réanimation Médicale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Baudry
authors.affiliation: Service de Réanimation Médico-chirurgicale, Groupement Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Faculté de Médecine Lyon-Sud, Université Claude Bernard Lyon 1, Université de Lyon, Pierre-Bénite, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Bohé
authors.affiliation: Service de Réanimation Médico-chirurgicale, Groupement Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Faculté de Médecine Lyon-Sud, Université Claude Bernard Lyon 1, Université de Lyon, Pierre-Bénite, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Piriou
authors.affiliation: Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France; Services de Réanimation Chirurgicale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Allaouchiche
authors.affiliation: Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France; Service d'Oto-Rhino-Laryngologie, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: François
authors.initials: F
authors.lastname: Disant
authors.affiliation: Service de Réanimation Médicale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Argaud
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D018450:Disease Progression; D004826:Epiglottitis / Q000382:microbiology* / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000150:complications*; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000150:complications*
chemical_list: D000893:Anti-Inflammatory Agents