Active Emergency Management of Adult Acute Epiglottitis: An Analysis of 570 Cases

Acute epiglottitis, which is primarily caused by bacterial infection, can quickly progress to life-threatening airway obstruction. The first 24 h after symptom onset is a critical window for management. However, few studies have evaluated the effect of emergency management during this period or have identified the factors that influence treatment outcomes.

This retrospective study includes a cohort of patients diagnosed with acute epiglottitis between December 2012 and December 2022. Patients are categorized based on whether they received improved emergency management. Medical records are systematically reviewed to assess the effect of emergency management and inflammatory markers on prognosis and length of hospitalization, as well as the risk factors for airway intervention.

In total, 570 patients are included. The number of acute epiglottitis cases each year keeps stable from 2012 to 2022. After implementation of improved emergency management, both mortality and hospital stay significantly decreased (p = 0.020 and p < 0.005, respectively). Hypertension (p = 0.041), diabetes (p = 0.009), epiglottic cysts (p = 0.015), and inflammatory markers are associated with longer hospital stay. Hypertension, diabetes, alcoholism, and high inflammatory marker levels are associated with airway intervention (p < 0.05).

The implementation of improved emergency management significantly reduces mortality and hospital stay duration in acute epiglottitis. The presence of epiglottic cysts is associated with a poorer patient prognosis. This study underscores the critical role of optimized emergency care in managing this condition.