Characteristics of Supraglottitis in Adults

Abstract

Objectives:

Describe the demographics, clinical presentation, interventions, and outcomes of adult patients diagnosed with acute supraglottitis.

Methods:

We retrospectively identified adult patients with acute supraglottitis during the years 1990 through 2013 by using relevant International Classification of Disease codes. Data were extracted for demographic and clinical information.

Results:

A total of 288 eligible patients were enrolled. Diagnosis was made by either indirect or fiber-optic laryngoscopy (or both modalities). The incidence rate of acute supraglottis was 4.3 out of 100,000 patients/year, with a steep rise during the years 1999 through 2013. A slight male predominance was observed (n = 160, 56%). The mean age was 50 ± 16 years, and 77% were 30 to 70 years old. Sore throat (94%) and dysphagia (88%) were the most common presenting symptoms, which had begun 2 days prior to hospitalization. Comorbidities were reported in 62% of the patients. Swabs were obtained in 17% of patients, of those 23% were positive. Patients were hospitalized either in the otolaryngology department (n = 255, 89%) or in the intensive care unit (ICU) (n = 33, 11%). Of the ICU patients, 19 (58%) had an airway securing intervention procedure (84% upon admission, 16% during initial 24 hours surveillance). Amoxicillin-clavulanate was administered in 61% of patients. Intravenous and inhalational corticosteroids were administered in 190 (66%) patients. The mortality rate was 0.003%.

Conclusions:

The signs and symptoms of supraglottitis in adults are different from those in the pediatric population. Patients presenting with sore throat, dysphagia, or odynophagia should be cautiously suspected for supraglottitis until proven otherwise. Treatment includes intravenous antibiotics and steroids and outcomes are excellent.