Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
Am J Otolaryngol. 2021 Mar-Apr;42(2):102882. doi: 10.1016/j.amjoto.2020.102882. Epub 2021 Jan 4.
Evaluate trends in mortality due to acute epiglottitis before and after adoption of Haemophilus influenza Type b vaccination (Hib) in pediatric and adult populations.
Patients who died from acute epiglottis from 1979 to 2017 identified using National Vital Statistics System. Mortality rates calculated using age-adjusted US census data expressed in rate per 100,000 individuals. Trends analyzed using the National Cancer Institute Joinpoint Regression Program (version 4.7.0; Bethesda, Maryland).
1187 epiglottitis-related deaths were identified over thirty-nine years. Total deaths decreased from 65 in 1979 to 15 in 2017. Adult deaths accounted for 63.5% and decreased from 0.015 per 100,000 individuals (24 deaths) in 1979 to 0.006 per 100,000 individuals (14 deaths) in 2017. Best fitting log-liner regression model showed APC of -3.5% (95% CI, -4.2 to -2.7%) from 1979 to 2017. Pediatric and adolescent deaths accounted for 443 (37.3%) deaths, decreasing from 0.064 per 100,000 individuals (41 deaths) in 1979 to 0.001 per 100,000 individuals (1 death) in 2017. APC was -11.1% (95% CI, -13.8% to -8.3%) in 1979 to 1990; 46.5% (95% CI, -16.6% to 157.3%) in 1990 to 1993; -61.6% (95% CI, -88% to 23%) in 1993 to 1996; and 1.1% (95% CI, -2.4% to 4.7%) in 1996 to 2017.
Mortality from acute epiglottitis decreased after widespread adoption of Hib vaccination in the US. Adults are now more likely than children to die of acute epiglottitis. Further research including multi-institutional cohort studies must be done to elucidate causative factors contributing to remaining cases of mortality.
评估小儿和成人人群接种流感嗜血杆菌 b 疫苗（Hib）前后急性会厌炎死亡率的变化趋势。
使用国家生命统计系统确定 1979 年至 2017 年间因急性会厌炎死亡的患者。使用年龄调整后的美国人口普查数据计算死亡率，以每 10 万人中的发生率表示。使用国家癌症研究所 Joinpoint 回归程序（版本 4.7.0；马里兰州贝塞斯达）分析趋势。
在三十九年期间共发现 1187 例与会厌炎相关的死亡病例。总死亡人数从 1979 年的 65 人下降到 2017 年的 15 人。成人死亡人数占 63.5%，从 1979 年每 10 万人中 0.015 人（24 例死亡）降至 2017 年每 10 万人中 0.006 人（14 例死亡）。最佳拟合对数线性回归模型显示，1979 年至 2017 年的 APC 为-3.5%（95%CI，-4.2%至-2.7%）。小儿和青少年死亡人数占 443 人（37.3%），从 1979 年每 10 万人中 0.064 人（41 例死亡）下降到 2017 年每 10 万人中 0.001 人（1 例死亡）。1979 年至 1990 年 APC 为-11.1%（95%CI，-13.8%至-8.3%）；1990 年至 1993 年 APC 为 46.5%（95%CI，-16.6%至 157.3%）；1993 年至 1996 年 APC 为-61.6%（95%CI，-88%至 23%）；1996 年至 2017 年 APC 为 1.1%（95%CI，-2.4%至 4.7%）。
在美国广泛接种 Hib 疫苗后，急性会厌炎死亡率下降。现在成年人死于急性会厌炎的可能性高于儿童。必须进行包括多机构队列研究在内的进一步研究，以阐明导致剩余死亡病例的致病因素。
