Epidemiology and resource utilization of ludwig's angina ED visits in the United States 2006-2014

Jamiela A McDonnough, Deawodi A Ladzekpo, Iasson Yi, William R Bond, Gezzer Ortega, Adedoyin O Kalejaiye
Laryngoscope 2019, 129 (9): 2041-2044

OBJECTIVES: Ludwig's angina is a potentially lethal submandibular space infection. We aim to describe the epidemiological characteristics of Ludwig's angina patients presenting to the emergency department (ED) and to examine outcomes and resource utilization to determine their burden on ED and hospitals.

METHODS: Using the Nationwide Emergency Department Sample database, a nationally representative all-payer database, we retrospectively reviewed all ED visits between 2006 and 2014 for patients admitted with a primary diagnosis of Ludwig's angina (International Classification of Diseases, Ninth Revision, 528.3). We collected information including demographics, ED and inpatient charges, airway interventions, length of stay, and mortality.

RESULTS: A total of 5,855 patients met our inclusion criteria. In our study population, the mean age was 44.5 years, with 54% males and 46% females. There were 75% insured and 25% uninsured. Overall median ED charges were $1,352 and median inpatient charges were $18,017.54, with a median length of stay of 3 days. As part of their management, 47.2% of the patients received a surgical drainage procedure, 3.3% required a surgical airway, and 4.6% required a nonsurgical airway. The overall mortality rate was 0.3%.

CONCLUSION: Ludwig's angina remains a rare and potentially life-threatening condition. The mortality rate appears to be decreased from previous historical accounts, with airway intervention remaining a significant part of management.

LEVEL OF EVIDENCE: 3 Laryngoscope, 129:2041-2044, 2019.

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