Long-term outcome of critically ill adult patients with acute epiglottitis

Autor: Julien Bohé, Vincent Piriou, Martin Cour, Thomas Baudry, Laurent Argaud, Romain Hernu, Bernard Allaouchiche, François Disant, Tomasz Chroboczek
Přispěvatelé: Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL)
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Adult
Male
medicine.medical_specialty
Epiglottitis/*microbiology/*therapy
Critical Care
Critical Illness
Science
medicine.medical_treatment
Adult/*complications
[SDV]Life Sciences [q-bio]
Anti-Inflammatory Agents
Epiglottitis
Disease
Anti-Inflammatory Agents/therapeutic use
law.invention
Streptococcal Infections/*complications
law
Streptococcal Infections
medicine
Intubation
Humans
Intensive care medicine
Retrospective Studies
Respiratory Distress Syndrome
Multidisciplinary
Acute epiglottitis
business.industry
Critically ill
Incidence (epidemiology)
Respiration
Retrospective cohort study
medicine.disease
Respiration
Artificial
Intensive care unit
3. Good health
Hospitalization
Intensive Care Units
Artificial
Disease Progression
Medicine
Female
business
Research Article
Critical Illness/*therapy
Zdroj: PLoS ONE
PLoS ONE, Public Library of Science, 2015, 10 (5), pp.e0125736. ⟨10.1371/journal.pone.0125736⟩
PLoS ONE, Vol 10, Iss 5, p e0125736 (2015)
ISSN: 1932-6203
Popis: International audience; BACKGROUND: Acute epiglottitis is a potentially life threatening disease, with a growing incidence in the adult population. Its long-term outcome after Intensive Care Unit (ICU) hospitalization has rarely been studied. METHODOLOGY AND PRINCIPAL FINDINGS: Thirty-four adult patients admitted for acute epiglottitis were included in this retrospective multicentric study. The mean age was 44 +/- 12 years (sex ratio: 5.8). Sixteen patients (47%) had a history of smoking while 8 (24%) had no previous medical history. The average time of disease progression before ICU was 2.6 +/- 3.6 days. The main reasons for hospitalization were continuous monitoring (17 cases, 50%) and acute respiratory distress (10 cases, 29%). Microbiological documentation could be made in 9 cases (26%), with Streptococcus spp. present in 7 cases (21%). Organ failure at ICU admission occurred in 8 cases (24%). Thirteen patients (38%) required respiratory assistance during ICU stay; 9 (26%) required surgery. Two patients (6%) died following hypoxemic cardiac arrest. Five patients (15%) had sequelae at 1 year. Patients requiring respiratory assistance had a longer duration of symptoms and more frequent anti inflammatory use before ICU admission and sequelae at 1 year (p \textless 0.05 versus non-ventilated patients). After logistic regression analysis, only exposure to anti-inflammatory drugs before admission was independently associated with airway intervention (OR, 4.96; 95% CI, 1.06-23.16). CONCLUSIONS AND SIGNIFICANCE: The profile of the cases consisted of young smoking men with little comorbidity. Streptococcus spp. infection represented the main etiology. Outcome was favorable if early respiratory tract protection could be performed in good conditions. Morbidity and sequelae were greater in patients requiring airway intervention.
Databáze: OpenAIRE
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