ISSN: 1859 - 2872
Survey of some factors related to the severity and initial treatment outcomes of anaphylaxis
Main Article Content
Keywords
Abstract
Objective: Survey of some factors related to the severity and initial treatment outcomes of anaphylaxis. Subject and method: A retrospective cross-sectional descriptive study of 203 patients diagnosed with anaphylaxis at the Emergency Department - 108 Military Central Hospital from 2021 to 2023. Collecting clinical characteristics and treatment trait. Evaluating the relationship of anaphylaxis severity with related factors and predictors of poor initial treatment outcomes. Result: Anaphylactic patients with a mean age of 45.59 (years), women accounted for 61.6%. No statistically significant relationship was found between the severity of anaphylaxis and the following causes: Drugs (p=0.235), food (p=0.082), insects (p=0.154) and other causes (p=0.143). There was no statistically significant relationship between the severity of anaphylaxis and the allergen entry route: Intravenous infusion (p=0.107); intramuscular injection (p=0.566); respiratory (p=1.00); ingestion (p=0.071), insect bites (p=0.253) and skin (p=0.570). Poor initial treatment outcomes were associated with time to start adrenaline injection from symptom onset > 30 minutes (OR = 1.54; 95% CI: 1.17-2.04) and adrenaline use more than 2 dose (OR = 16.7; 95% CI: 1.11- 253.71). Conclusion: The severity of anaphylaxis did not depend on the cause and the route of entry of the allergen causing anaphylaxis. Poor initial treatment outcomes were associated with late initiation of adrenaline and use more than two doses of adrenaline.
Article Details
References
2. Kim SY, Kim MH, Cho YJ (2018) Different clinical features of anaphylaxis according to cause and risk factors for severe reactions. Allergol Int 67(1): 96-102. doi:10.1016/j.alit.2017.05.005.
3. Bộ Y tế (2017) Hướng dẫn phòng, chẩn đoán và xử trí phản vệ. Thông tư 51/2017 BYT.
4. Ahanchian H, Behmanesh F, Azad FJ et al (2018) A survey of anaphylaxis etiology and treatment. Med Gas Res 8(4): 129-134. doi:10.4103/2045-9912.248262.
5. Brown SG (2004) Clinical features and severity grading of anaphylaxis. J Allergy Clin Immunol 114(2):371-376. doi:10.1016/j.jaci.2004.04.029.
6. Motosue MS, Bellolio MF, Van Houten HK, Shah ND, Campbell RL (2017) Increasing Emergency Department Visits for Anaphylaxis, 2005-2014. J Allergy Clin Immunol Pract 5(1): 171-175. doi: 10.1016/j.jaip.2016.08.013.
7. Pourmand A, Robinson C, Syed W, Mazer-Amirshahi M (2018) Biphasic anaphylaxis: A review of the literature and implications for emergency management. Am J Emerg Med 36(8): 1480-1485. doi:10.1016/j.ajem.2018.05.009.
8. Simons FE, Ardusso LR, Bilò MB et al (2011) World allergy organization guidelines for the assessment and management of anaphylaxis. World Allergy Organ J 4(2): 13-37. doi:10.1097/WOX.0b013e318211496c.
9. Ye YM, Kim MK, Kang HR et al (2015) Predictors of the severity and serious outcomes of anaphylaxis in korean adults: a multicenter retrospective case study. Allergy Asthma Immunol Res 7(1): 22-29. doi:10.4168/aair.2015.7.1.22.
10. Brown SG, Stone SF, Fatovich DM et al (2013) Anaphylaxis: clinical patterns, mediator release, and severity. J Allergy Clin Immunol 132(5): 1141-1149.e5. doi:10.1016/j.jaci.2013.06.015.
11. Alqurashi W, Stiell I, Chan K, Neto G, Alsadoon A, Wells G (2015) Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis. Ann Allergy Asthma Immunol115(3):217-223.e2. doi:10.1016/j.anai.2015.05.013.
12. Shaker MS, Wallace DV, Golden DBK, et al (2020) Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol 145(4): 1082-1123. doi:10.1016/j.jaci.2020.01.017.
13. Liu X, Lee S, Lohse CM, Hardy CT, Campbell RL (2020) Biphasic reactions in emergency department anaphylaxis patients: a prospective cohort study. J Allergy Clin Immunol Pract 8(4): 1230-1238. doi:10.1016/j.jaip.2019.10.027.
Article Sidebar
