ADULT SUPRAGLOTTITIS

Airway management of supraglottitis in the adult is controversial as r egards the choice between observation and acute intervention. This stu dy was undertaken to determine whether factors exist that place patien ts at higher risk of airway obstruction and to review conservative tre atment outcome. Of 46 cases during an 8-year period, seven required tr acheostomy and 39 were observed. Odynophagia and fever were present in all patients. Yearly clusters of up to six cases in i month were dete cted. White blood cell count and heart rate were significantly more el evated in those who underwent tracheostomy. A symptom duration of less than 24 hours was associated (p < 0.05, chi2 analysis) with airway co mpromise as well. There was no associated morbidity or mortality, and mean hospital stay was 5.2 days for those observed and 7.9 days for th ose who underwent tracheostomy.