Abstract：
BACKGROUND: A biphasic allergic reaction develops in 0.4-20% of patients with an allergic reaction, but the incidence of severe biphasic reactions is unknown OBJECTIVE: Our objective was to assess the incidence and time of onset of clinically relevant biphasic reactions in a Dutch emergency department (ED) cohort. Furthermore, the characteristics of patients with a biphasic reaction and the mean observation time after an allergy-related ED visit were assessed.
METHODS: This was a single-center retrospective cohort study. We collected data from clinical records of adult patients presenting with an allergic reaction to the ED between January 2015 and December 2019. We defined clinically relevant biphasic reactions as biphasic reactions in which the criteria for anaphylaxis were met.
RESULTS: Five hundred fifty-seven patients were included. Eight patients (1.4%) developed a biphasic reaction, of which 1 (0.2% of the total inclusions) was clinically relevant. In the subgroup of patients with an anaphylactic reaction (n = 258), those percentages were 2.3% and 0.4%, respectively. The mean time between the initial allergic reaction and the biphasic allergic reaction was 25.4 h (95% CI 13.2-37.6 h). The single clinically relevant biphasic reaction occurred 30 h after the initial reaction.
CONCLUSIONS: The incidence of clinically relevant biphasic reactions in our cohort was low, with a mean time between the initial allergic reaction and the biphasic reaction of > 24 h. Based on these single-center retrospective data, routine inpatient monitoring for several hours does not seem warranted for all patients.
METHODS: This was a single-center retrospective cohort study. We collected data from clinical records of adult patients presenting with an allergic reaction to the ED between January 2015 and December 2019. We defined clinically relevant biphasic reactions as biphasic reactions in which the criteria for anaphylaxis were met.
RESULTS: Five hundred fifty-seven patients were included. Eight patients (1.4%) developed a biphasic reaction, of which 1 (0.2% of the total inclusions) was clinically relevant. In the subgroup of patients with an anaphylactic reaction (n = 258), those percentages were 2.3% and 0.4%, respectively. The mean time between the initial allergic reaction and the biphasic allergic reaction was 25.4 h (95% CI 13.2-37.6 h). The single clinically relevant biphasic reaction occurred 30 h after the initial reaction.
CONCLUSIONS: The incidence of clinically relevant biphasic reactions in our cohort was low, with a mean time between the initial allergic reaction and the biphasic reaction of > 24 h. Based on these single-center retrospective data, routine inpatient monitoring for several hours does not seem warranted for all patients.
摘要：
背景：0.4-20％的患者发生双相过敏反应，但严重双相反应的发生率未知。目的：我们的目的是评估荷兰急诊科（ED）队列中临床相关双相反应的发生率和发病时间。此外，评估了双相反应患者的特征和过敏相关ED访视后的平均观察时间.
方法：这是一项单中心回顾性队列研究。我们从2015年1月至2019年12月期间对ED出现过敏反应的成年患者的临床记录中收集数据。我们将临床相关的双相反应定义为符合过敏反应标准的双相反应。
结果：纳入557例患者。8例患者（1.4%）出现双相反应，其中1例(占总包涵体的0.2%)与临床相关。在有过敏反应的患者亚组（n=258）中，这些百分比分别为2.3%和0.4%，分别。初始过敏反应和双相过敏反应之间的平均时间为25.4h（95％CI13.2-37.6h）。单个临床相关的双相反应发生在初始反应后30小时。
结论：我们队列中临床相关双相反应的发生率较低，初始过敏反应和双相反应之间的平均时间>24小时。基于这些单中心回顾性数据，似乎并非所有患者都需要进行数小时的常规住院监测.
方法：这是一项单中心回顾性队列研究。
结果：纳入557例患者。
结论：我们队列中临床相关双相反应的发生率较低，
