Abstract
BACKGROUND: Non-infectious epiglottitis, an infrequent but significant condition, presents challenges in airway management and treatment due to its potential for rapid progression. OBJECTIVE: To analyze differences in clinicodemographic characteristics, management strategies, and clinical outcomes between pediatric and adult cases of non-infectious epiglottitis. METHODS: A systematic search of four databases identified 57 patient records, all diagnosed with non-infectious epiglottitis. Children (<18 years) were compared to adults (≥18 years). Differences in clinicodemographic characteristics, management strategies, and clinical outcomes were analyzed. Outcomes included intubation, complications, and intensive care unit (ICU) admission. Risk factors of these outcomes were identified through uni- and multi-variable logistic regression analyses. RESULTS: Twenty-three children and 34 adults were analyzed. The presentation with stridor (56.52% vs. 14.7%), drooling (56.52% vs. 26.47%), cyanosis (17.39% vs. 0%), and sternal retraction (13.04% vs. 0%) was more common among children. Prior vaccination was evident in only 5 pediatric cases. The etiology of epiglottitis was similar across groups. Children had significantly higher chances of receiving epinephrine (34.78% vs. 8.82%), undergoing intubation (82.60% vs. 20.58%), being admitted to the ICU (56.52% vs. 17.64%), and having complications (47.82% vs. 14.70%), compared to adults. In the multivariate regression model, pediatric age was a risk factor for intubation (p = 0.015) and ICU admission (p = 0.040), while foreign body ingestion (p = 0.039) and dyspnea (p = 0.014) were predictors of intubation and complications, respectively. CONCLUSIONS: The study highlights the necessity for age-specific management strategies in non-infectious epiglottitis. Understanding the distinct clinical presentations and responses in different age groups can lead to improved patient care.