Korean J Pediatr.  2015 Oct;58(10):380-385. 10.3345/kjp.2015.58.10.380.

Clinical characteristics of children and adolescents with croup and epiglottitis who visited 146 Emergency Departments in Korea

Affiliations
  • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Pediatrics, National Medical Center, Seoul, Korea. ehchung@nmc.or.kr
  • 3Department of Pediatrics, Sun General Hospital, Daejeon, Korea.
  • 4Department of Pediatrics, Incheon Medical Center, Incheon, Korea.

Abstract

PURPOSE
Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients.
METHODS
The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged < or =18 years presenting with croup or epiglottitis.
RESULTS
We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were 2.2+/-2.0 and 5.6+/-5.8 years, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P<0.05).
CONCLUSION
Both groups had similar sex ratios, arrival times, 3 most common chief complaints, and 5 most common comorbidities. Epiglottitis patients had a lower incidence rate, higher mean age of onset, and higher hospitalization rate and experienced dyspnea, sore throat, and vomiting more often than croup patients. Our results may help in the differential diagnosis of croup and epiglottitis.

Keyword

Croup; Epiglottitis; Emergency Department

MeSH Terms

Adolescent*
Age of Onset
Airway Obstruction
Child*
Comorbidity
Cough
Croup*
Diagnosis, Differential
Dyspnea
Emergencies*
Emergency Service, Hospital*
Epiglottitis*
Fever
Hospitalization
Humans
Incidence
Information Systems
Intensive Care Units
Korea*
Pharyngitis
Rare Diseases
Sex Ratio
Vomiting
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