Comparison of Scope Classifications for Predicting the Need for Airway Intervention in Acute Supraglottitis

Abstract

Background Acute supraglottitis (AS) can cause airway obstruction, sometimes necessitating airway intervention. Some scope classifications were developed to predict the need for airway intervention in patients with AS; however, the most suitable classification for predicting the need for airway intervention remains unclear. Objective This study was performed to validate and compare the usefulness of three scope classifications (Katori's, Tanaka's, and Ovnat-Tamir's classifications) for predicting the need for airway intervention in patients with AS. Materials and Methods We recruited 75 patients (44 males and 31 females aged 20–94 years) with AS who visited Kurashiki Central Hospital between January 2015 and September 2019. The areas under the receiver operating characteristic curves (AUCs) of the scope classifications for predicting the need for airway intervention were measured. Results Of the 75 patients, airway intervention was needed in 23 patients. The AUC was 0.818 (95% confidence interval [CI]: 0.715–0.922) for Katori's classification, 0.803 (95% CI: 0.699–0.907) for Tanaka's classification, and 0.814 (95% CI: 0.705–0.922) for Ovnat-Tamir's classification. Conclusion Although all three classifications appeared to be useful, the AUC tended to be the highest for Katori's classification.

Acute infectious supraglottitis in adult population: epidemiology, management, outcomes and predictors of airway intervention

“…The meta-analysis of Sideris et al [ 5 ] describes an overall 1.5% mortality rate, which is consistent with our results. Some papers also described post-anoxic encephalopathy in relation to airway collapse [ 15 , 21 ], like in our study. A previous study [ 4 ] showed that BMI > 25 kg/m 2 is an independent risk factor for developing severe epiglottitis and is associated with relatively higher 2-day mortality.…”

“…3 and 4 ) was very similar. Different scoring systems for prediction of airway intervention have been proposed in the literature [ 15 ], but none of them could be applied in our study due to its retrospective design.…”

Acute epiglottitis caused by COVID-19: A systematic review

“…Depending on the severity of the patient’s dyspnea, airway management techniques, such as tracheal intubation, cricothyrotomy, and tracheotomy, may be used to maintain a normal airway. The Katori, Tanaka, and Ovnat-Tamir classifications can all be used to determine if airway interventions are necessary for patients with AE [ 35 ]. According to a study from Spain, airway intervention was required for 17% of patients with AE, and epiglottic abscesses, hypersalivation, and smoking may be risk factors [ 36 ].…”