Page 64 - Portuguese Journal - SPORL - Vol 61. Nº2

epiglottitis can be challenging, and identifying pain”; U for “unresponsive”) 7, 8 . The sum varies
risk factors in patients who may require between 0 and 14, and a score higher than 4 is
airway protection is extremely important. The associated with an increased risk of death or
treatment of epiglottitis includes monitoring admission to the intensive care unit (Table 1).
the permeability of the airway, administration The outcomes were defined as the main
of intravenous antibiotics, and detecting complications of epiglottitis: need for
complications such as epiglottic abscess, advanced airway management (AAM)—
deep cervical infection, and obstruction of the orotracheal intubation or tracheotomy;
airway . This study aimed to characterize the presence of cervical and/or epiglottic abscess;
6
adult population diagnosed with epiglottitis need for surgical drainage. Furthermore, the
and identify potential risk factors for relationship between the assessed parameters
complications. and length of hospital stay was investigated.
Statistical analysis was performed using
Materials and Methods descriptive analysis and non-parametric
This was a retrospective observational tests—the chi-square test or Fisher’s exact test
study that included all adults (>18 years) (where applicable), Spearman’s correlation,
admitted for epiglottitis in Centro Hospitalar Mann-Whitney U test, Kruskal-Wallis test, and
Universitário Lisboa Norte, conducted multivariate analysis of variance (MANOVA).
over six years between January 2017 and For the statistically significant parameters in
December 2022. The medical records were MANOVA, between-subject effects analysis
reviewed to characterize the population. and post-hoc tests were performed. The
The collected data included the following: 1) statistical tests were performed using the
demographic data (age; sex; comorbidities IBM SPSS Statistics v.29 softwar e. Statistical
such as hypertension, diabetes mellitus, significance was set at p ≤0.05.
and obesity; smoking habits); 2) clinical data
(symptoms, imaging exams, endoscopic and Results
analytical findings, and number of days of The sample included a total of 51 adults with
hospital stay). The diagnosis in all patients was a mean age of 47 years (between 19 and
confirmed by direct endoscopic visualization 84 years), comprising 32 men (62.7%) and
at the ENT emergency department (SU). The 19 women (37.3%). Regarding their clinical
Modified Early Warning Score (MEWS) was history, 28 patients (54.9%) had comorbidities,
used to determine the patient’s clinical status the most frequent being hypertension and
on admission to the SU. This score evaluates dyslipidemia, and 31.4% of the patients were
the degree of disease severity based on five smokers. The most common symptom was
vital parameters: blood pressure; heart rate; odynophagia (96.1%), followed by dysphagia
respiratory rate; body temperature; state of (68.6%), fever (45.1%), dysphonia and dyspnea
consciousness (AVPU scale – A for “alert”; V (both affecting 35.3% of the sample), and
for “response to voice”; P for “response to hypersalivation (19.6%) The frequency of the

Table 1
Modified Early Warning Score (MEWS)

Score 3 2 1 0 1 2 3
Pressure (mm Hg) <70 71-80 81-100 101-199 ≥200
Heart rate (bpm) <40 41-50 51-100 101-110 111-129 ≥130
Respiratory rate (cpm) <9 9-14 15-20 21-29 ≥30
Temperature (ºC) <35 35-38.4 ≥38.5
APVU scale Alert Voice Pain Un responsive

206 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery