Airway management in pediatric epiglottitis: a national perspective.

OBJECTIVES The purpose of this study was to describe current demographics and resource utilization in the treatment of pediatric epiglottitis. STUDY DESIGN Case series from a national database. SUBJECTS AND METHODS The Kids' Inpatient Database was systematically searched to extract patients under 19 years old admitted with a diagnosis of epiglottitis and undergoing an airway intervention. RESULTS Three hundred forty-two sampled admissions were for epiglottitis; 40 of these patients were under the age of 19 and had an airway intervention (intubation or tracheotomy). On average, patients were 4.3 years old (SD = 6.0 years). The average length of stay was 15.6 days (SD = 33.9 and range = 0-199) with average total charges of $74,931 (SD = $163,387, range = $3342-$938,512). Multivariate analysis revealed that admission to a children's facility, admission other than via the emergency room, and nonemergent admission were associated with increased total charges. Twenty-two states reported an admission for pediatric epiglottitis that required airway intervention. CONCLUSIONS In our sample, only 40 patients were identified who were under the age of 19 years and required an airway intervention for the treatment of epiglottitis. Epiglottitis is a rare, expensive, and protracted disease to treat in the postvaccine era. The unique nature of this disease has implications for training future surgeons on proper management of this potentially fatal disease.