Airway Management of Epiglottitis: A National Perspective

Objective To describe demographics and utilization in the treatment of epiglottitis. Methods The Kids’ Inpatient Database (KID) was used to extract data for patients 7 years old and younger with a diagnosis of epiglottitis; children undergoing airway intervention (intubation or tracheostomy) were studied. Results 33 patients were identified that were either intubated (n=31) or had a tracheotomy (n=3); 1 patient that had a tracheotomy was intubated prior. The mean age of patients was 1.7 years old; 58% being 2 years older or less. 52% were male, and 42% were Caucasian. Average length of stay was 17.7 days (range=0–199). January and October were the most common months for admission (n=5, each). Of admissions - Texas and Massachusetts handled the most (n=4, each). Average total charges were $83860. Private insurance was the primary payor in 55% of cases; 18% patients were discharged to shortterm care facilities. 73% of cases were managed at teaching hospitals; all tracheotomies were at teaching hospitals. There were no mortalities. Conclusions In the post-HiB era, epiglottitis has become a rare entity. Of children under 7 years of age, only 33 required airway intervention in the 36 states sampled in 2003. More than half of affected children were, on average, 2 years old and younger. Airway intervention for epiglottitis is associated with high total charges and prolonged hospitalization. Epiglottitis is a rare, expensive, and protracted disease to treat in the HiB vaccine era. The infrequency of this disease has significant implications for resident education and training.