{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:14:35Z","timestamp":1777634075535,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adult epiglottitis is an uncommon but potentially life\u2010threatening condition requiring rapid recognition and airway\u2010focused management, yet evidence regarding early medical therapy is limited. We evaluated temporal trends in adult epiglottitis and examined associations between early corticosteroid or antibiotic therapy and clinically important outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adults (\u2265\u200918\u2009years) presenting to U.S. emergency departments with acute epiglottitis between 2014 and 2024 using the TriNetX Research Network. Cases were identified using the ICD\u201010 code J05.1; patients with preexisting tracheostomy were excluded. Early therapy was defined as systemic corticosteroid or parenteral antibiotic administration within 24\u2009h of presentation. The primary outcome was endotracheal intubation; secondary outcomes included ICU admission, 30\u2010day ED recidivism, and 30\u2010day mortality. Propensity score matching (1:1) and multivariable Cox proportional hazards models were used to estimate risk ratios (RRs) and hazard ratios (HRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The annual incidence proportion of adult epiglottitis increased from 0.002% in 2014 to 0.005% in 2024 (RR per year 1.09; 95% CI 1.08\u20131.10), with the steepest rise among adults aged 60\u201374\u2009years. In matched cohorts, early corticosteroid therapy was associated with lower risks of intubation (RR 0.48; 95% CI 0.26\u20130.88) and ICU admission (RR 0.71; 95% CI 0.55\u20130.92). Early antibiotic therapy demonstrated similar associations for intubation (RR 0.54; 95% CI 0.34\u20130.85) and ICU admission (RR 0.72; 95% CI 0.60\u20130.86). In adjusted Cox models, early steroids (HR 0.33; 95% CI 0.25\u20130.44) and early antibiotics (HR 0.50; 95% CI 0.34\u20130.75) were independently associated with lower hazards of intubation. Older age, comorbidities, and hypoxia were strong predictors of airway compromise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adult epiglottitis incidence has increased over the past decade, particularly among older adults. Early corticosteroid and antibiotic therapy were independently associated with lower risks of intubation and ICU admission, supporting current clinical practice favoring timely medical therapy in adults with suspected epiglottitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70285","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T09:29:01Z","timestamp":1776936541000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Early Steroid and Antibiotic Therapy With Airway Outcomes in Adult Epiglottitis: A 10\u2010Year Multicenter Retrospective Cohort Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9905-7139","authenticated-orcid":false,"given":"Joseph","family":"O'Brien","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Denver Health Medical Center  Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic R.","family":"Muccio","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon W.","family":"Schrock","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine MetroHealth Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ANORL.2020.12.001"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AMJOTO.2020.102882"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ANL.2008.03.012"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196\u20100709(03)00083\u20108"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.5152\/TAO.2015.718"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.22037\/aaem.v12i1.2351"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AJEM.2022.04.018"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/CUREUS.49984"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0B013E328320AD2F"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.22147"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.06.153"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.28076"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.25114"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.7759\/CUREUS.73387"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2344\/ANPR\u201066\u201004\u201008"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010197406000\u201000005"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.30110"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010198007000\u201000011"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.27741"}],"container-title":["Academic 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