An analysis of prognosis risk factors in sever acute epiglottitis / 中华急诊医学杂志

ABSTRACT

Objective To confirm the risk factors of poor prognosis in patients with severe acute epiglottitis by comparing symptoms and results of laboratory tests.Methods A total of 698 patients with acute epiglottitis from outpatient and emergency room from 1995 to 2014 were retrospectively studied.These patients were divided into severe or mild group as per the means of treatment of airway including invasive (n =115)and non-invasive (n =583).The past history,general conditions and laboratory tests were compared between the two groups by chi-square or t test;the spearman correlation between the degree of dyspnea and epiglottis edema was analyzed,and the risk factors of poor prognosis were detected by logistic regression.Results The ratio of male to female was 1.366/1.There was a high prevalence of sever acute epiglottitis in spring,winter and at night, respectively.More smokers were found in the severe group compared with the mild group (χ2 =41.957,P <0.01).Severe dyspnea and low PaO2 (r =0.573,P <0.01),but not the poor grading of epiglottis edema evaluated by pharyngo-fiberoscope (r =-0.024,P =0.525),were correlated with poor prognosis.Male (OR =1.84,95%CI1.41 -3.22,P =0.001),an attack at night (OR =2.61,95%CI1.98 -3.16),P =0.07), smoker (OR =1.63,95%CI1.05 -3.39,P =0.04)and low PaO2 (OR =2.97,95%CI1.58 -4.49,P =0.02)were independent risk factors for a poor prognosis.Conclusions Male,an attack at night,smoker and low PaO2 were independent risk factors for a poor prognosis of acute epiglottitis.A critical care should be given to patients with those risk factors,even their epiglottis edema was not very serious.