Epidemiology
A study from the US estimated the incidence of acute epiglottitis decreased from 3.47 per 100,000 in 1980 to 0.63 per 100,000 in 1990.[6] During the same interval, the ratio of epiglottitis in children to adults decreased from 2.6 in 1980 to 0.4 in 1990. These demographic changes have been ascribed to the use of the Haemophilus influenzae type B (Hib) vaccine. One 10-year retrospective study at a tertiary care children's hospital found that the mean age of children with epiglottitis increased from 5.8 years during 1992 and 1997 to 11.6 years during 1998 and 2002.[3] Another US study identified 342 pediatric patients and 40 airway interventions related to epiglottitis out of 2,984,129 hospital inpatient discharges in the year 2003.[7] Males and white people are more frequently affected.[3] Another US study, which involved 33,549 adult patients from 2007 to 2014, found that the average patient age for adult epiglottitis increased significantly from 47 to 51 years (R2 >0.5) over the study period, with an overall mean age of 49 years.[8]
A retrospective review from two tertiary care facilities identified 60 adults and 1 child with epiglottitis. Eleven of these patients required intubation and 2 required tracheotomy.[9] One systematic review and meta-analysis, which included 30 studies and a total of 10,148 adult patients, identified a significant decrease in the need for airway intervention in the post-Hib vaccine era, and found that clinicians should expect to have to secure airways in 10.9% of adult patients with epiglottitis.[10]
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