Lin Pei-Chen, Liao Yu-Ying, Hsu Chien-Chin, Vong Si-Chon, Chen Kuo-Tai
Emergency Department, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan; Department of Biotechnology, Southern Tainan University of Technology, Tainan, Taiwan.
Am J Emerg Med. 2014 Nov;32(11):1334-8. doi: 10.1016/j.ajem.2014.08.033. Epub 2014 Aug 21.
This study aimed to assess the differences in the clinical characteristics, management, and outcomes of supraglottitis between geriatric and nongeriatric adults over a 30-month period.
All adult patients admitted to the emergency department with suspected supraglottitis and who underwent laryngoscopy for confirmation were included. We collected the clinical characteristics, management, and outcomes of these patients and compared geriatric (≥60 years old) and nongeriatric (12-59 years old) groups in terms of these data.
Eighty-one geriatric patients and 205 nongeriatric patients were reviewed during the study period. The accuracies of the clinical suspicions of supraglottitis were lower in the geriatric group (geriatric vs nongeriatric, 29.4% vs 47.3%, P = .008). The geriatric group constituted 19.8% of all supraglottitis patients. Comorbidities were discovered in 74.1% of the geriatric group and 25.4% of the nongeriatric group (P = .000). The complication rate in the geriatric patients was almost twice that of the nongeriatric patients (20.8% vs 10.8%). Additionally, the geriatric patients exhibited tendencies toward longer periods of intubation, hospitalization, and stay in the intensive care unit.
The clinical characteristics and management were similar between the geriatric and nongeriatric supraglottitis patients. Nevertheless, the comorbidities altered the clinical presentations of the geriatric patients and resulted in lower diagnostic accuracy. Additionally, the elevated complication rates of the geriatric patient might have negatively affected their outcomes.
本研究旨在评估30个月期间老年与非老年成人会厌炎的临床特征、治疗及预后差异。
纳入所有因疑似会厌炎入住急诊科并接受喉镜检查以确诊的成年患者。我们收集了这些患者的临床特征、治疗及预后情况，并就这些数据对老年组（≥60岁）和非老年组（12 - 59岁）进行比较。
研究期间共纳入81例老年患者和205例非老年患者。老年组对会厌炎临床怀疑的准确率较低（老年组与非老年组分别为29.4%和47.3%，P = 0.008）。老年患者占所有会厌炎患者的19.8%。老年组74.1%的患者发现有合并症，非老年组为25.4%（P = 0.000）。老年患者的并发症发生率几乎是非老年患者的两倍（20.8%对10.8%）。此外，老年患者在插管、住院及重症监护病房停留时间有延长趋势。
老年与会厌炎非老年患者的临床特征及治疗相似。然而，合并症改变了老年患者的临床表现，导致诊断准确率降低。此外，老年患者较高的并发症发生率可能对其预后产生了负面影响。
