Although traditionally common in children, with the advent of the Haemophilus influenzae type b (Hib) vaccine, pediatric incidence of epiglottitis has declined.[6]Hanna J, Brauer PR, Berson E, et al. Adult epiglottitis: trends and predictors of mortality in over 30 thousand cases from 2007 to 2014. Laryngoscope. 2019 May;129(5):1107-12.
http://www.ncbi.nlm.nih.gov/pubmed/30582183?tool=bestpractice.com
[7]Bridwell RE, Koyfman A, Long B. High risk and low prevalence diseases: adult epiglottitis. Am J Emerg Med. 2022 Jul;57:14-20.
http://www.ncbi.nlm.nih.gov/pubmed/35489220?tool=bestpractice.com
[8]Allen M, Meraj TS, Oska S, et al. Acute epiglottitis: analysis of U.S. mortality trends from 1979 to 2017. Am J Otolaryngol. 2021 Mar-Apr;42(2):102882.
http://www.ncbi.nlm.nih.gov/pubmed/33429180?tool=bestpractice.com
In contrast, a steady increase in the incidence has been seen in adults, with men being more commonly affected.[7]Bridwell RE, Koyfman A, Long B. High risk and low prevalence diseases: adult epiglottitis. Am J Emerg Med. 2022 Jul;57:14-20.
http://www.ncbi.nlm.nih.gov/pubmed/35489220?tool=bestpractice.com
One US study, which involved 33,549 adult patients from 2007 to 2014, found that the average patient age for adult epiglottitis increased significantly from 47 to 51 years (R2 >0.5) over the study period, with an overall mean age of 49 years.[6]Hanna J, Brauer PR, Berson E, et al. Adult epiglottitis: trends and predictors of mortality in over 30 thousand cases from 2007 to 2014. Laryngoscope. 2019 May;129(5):1107-12.
http://www.ncbi.nlm.nih.gov/pubmed/30582183?tool=bestpractice.com
One retrospective review from two tertiary care facilities identified 60 adults and 1 child with epiglottitis. Eleven of these patients required intubation and 2 required tracheotomy.[9]Guardiani E, Bliss M, Harley E. Supraglottitis in the era following widespread immunization against Haemophilus influenzae type B: evolving principles in diagnosis and management. Laryngoscope. 2010 Nov;120(11):2183-8.
http://www.ncbi.nlm.nih.gov/pubmed/20925091?tool=bestpractice.com
One systematic review and meta-analysis, which included 30 studies and a total of 10,148 adult patients, identified a significant decrease in the need for airway intervention in the post-Hib vaccine era, and found that clinicians should expect to have to secure airways in 10.9% of adult patients with epiglottitis.[10]Sideris A, Holmes TR, Cumming B, et al. A systematic review and meta-analysis of predictors of airway intervention in adult epiglottitis. Laryngoscope. 2020 Feb;130(2):465-73.
http://www.ncbi.nlm.nih.gov/pubmed/31173373?tool=bestpractice.com
The overall mortality rate in adults is around 1%.[6]Hanna J, Brauer PR, Berson E, et al. Adult epiglottitis: trends and predictors of mortality in over 30 thousand cases from 2007 to 2014. Laryngoscope. 2019 May;129(5):1107-12.
http://www.ncbi.nlm.nih.gov/pubmed/30582183?tool=bestpractice.com
One retrospective study reported that adults are more likely to die of acute epiglottitis than children, as 63% of deaths in the study were accounted for by adult patients with epiglottitis.[8]Allen M, Meraj TS, Oska S, et al. Acute epiglottitis: analysis of U.S. mortality trends from 1979 to 2017. Am J Otolaryngol. 2021 Mar-Apr;42(2):102882.
http://www.ncbi.nlm.nih.gov/pubmed/33429180?tool=bestpractice.com