Clinical features of anaphylaxis and risk factors of severe anaphylaxis in the emergency department
- Author:
Seong Woo KIM
1
;
Young Ho JIN
;
Tae Oh JEONG
;
Jae Chol YOON
;
So Eun KIM
;
Tae Hwan OH
;
Sang Min KIM
;
Jae Baek LEE
Author Information
1. Department of Emergency Medicine, Jeonbuk National University Hospital, Jeonju, Korea
- Publication Type:Original Article
- From:Journal of the Korean Society of Emergency Medicine
2023;34(1):79-86
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Objective:This study investigates the triggers and clinical features of anaphylaxis, and determines the risk factors associated with severe anaphylaxis.
Methods:This is a retrospective observational study spanning a duration of 2 years (2020-2021) using the electronic data of patients diagnosed with anaphylaxis in the university-affiliated emergency center. Severe anaphylaxis was defined as refractory anaphylaxis requiring ≥3 times epinephrine administration and/or continuous epinephrine infusion. Baseline and clinical characteristics were compared between the severe and the non-severe anaphylaxis groups. Binary logistic regression analysis was performed to reveal independent risk factors associated with severe anaphylaxis.
Results:The median age of study patients was determined to be 53.0 years (range, 37.5-65.0 years). Fifty-eight patients (58.0%) were male. Drugs were found to be the most common trigger. In clinical manifestations, cutaneous manifestation was the most common. Severe anaphylaxis occurred in 19 patients (19.0%). Latent time was shorter in the severe anaphylaxis group-10.0 minutes (5.0-20.0) vs. 30.0 minutes (10.0-60.0), P<0.001. Drug as a trigger (68.4% vs. 39.5%, P=0.023), hypotension (57.9% vs. 9.9%, P<0.001), cardiovascular manifestation (84.2% vs. 40.7%, P=0.001), and hyperlactatemia (73.7% vs. 46.9%, P=0.036) were more frequently observed in the severe anaphylaxis group. Shorter latent time, drug as a trigger, and presence of hypotension were independent risk factors for severe anaphylaxis.
Conclusion:Anaphylaxis patients with shorter latent time, diagnosed with drugs as a trigger, and presenting with hypotension, must be subjected to careful monitoring and early active treatment.
