PDF(Pubmed)
Abstract：
BACKGROUND: Anaphylaxis is the most severe form of acute systemic and potentially life-threatening reactions triggered by mast and basophilic cells. Recent studies show a worldwide incidence between 50 and 112 occurrences per 100,000 person-years. The most identified triggers are food, medications, and insect venoms. We aimed to analyze triggers and clinical symptoms of patients presenting to a Swiss university emergency department for adults.
METHODS: Six-year retrospective analysis (01/2013 to 12/2018) of all patients (> 16 years of age) admitted with moderate or severe anaphylaxis (classification of Ring and Messmer ≥ 2) to the emergency department. Patient and clinical data were extracted from the electronic medical database of the emergency department.
RESULTS: Of the 531 includes patients, 53.3% were female, the median age was 38 [IQR 26-51] years. The most common suspected triggers were medications (31.8%), food (25.6%), and insect stings (17.1%). Organ manifestations varied among the different suspected triggers: for medications, 90.5% of the patients had skin symptoms, followed by respiratory (62.7%), cardiovascular (44.4%) and gastrointestinal symptoms (33.7%); for food, gastrointestinal symptoms (39.7%) were more frequent than cardiovascular symptoms (36.8%) and for insect stings cardiovascular symptoms were apparent in 63.8% of the cases.
CONCLUSIONS: Average annual incidence of moderate to severe anaphylaxis during the 6-year period in subjects > 16 years of age was 10.67 per 100,000 inhabitants. Medications (antibiotics, NSAID and radiocontrast agents) were the most frequently suspected triggers. Anaphylaxis due to insect stings was more frequently than in other studies. Regarding clinical symptoms, gastrointestinal symptoms need to be better considered, especially that initial treatment with epinephrine is not delayed.
METHODS: Six-year retrospective analysis (01/2013 to 12/2018) of all patients (> 16 years of age) admitted with moderate or severe anaphylaxis (classification of Ring and Messmer ≥ 2) to the emergency department. Patient and clinical data were extracted from the electronic medical database of the emergency department.
RESULTS: Of the 531 includes patients, 53.3% were female, the median age was 38 [IQR 26-51] years. The most common suspected triggers were medications (31.8%), food (25.6%), and insect stings (17.1%). Organ manifestations varied among the different suspected triggers: for medications, 90.5% of the patients had skin symptoms, followed by respiratory (62.7%), cardiovascular (44.4%) and gastrointestinal symptoms (33.7%); for food, gastrointestinal symptoms (39.7%) were more frequent than cardiovascular symptoms (36.8%) and for insect stings cardiovascular symptoms were apparent in 63.8% of the cases.
CONCLUSIONS: Average annual incidence of moderate to severe anaphylaxis during the 6-year period in subjects > 16 years of age was 10.67 per 100,000 inhabitants. Medications (antibiotics, NSAID and radiocontrast agents) were the most frequently suspected triggers. Anaphylaxis due to insect stings was more frequently than in other studies. Regarding clinical symptoms, gastrointestinal symptoms need to be better considered, especially that initial treatment with epinephrine is not delayed.
摘要：
背景：过敏反应是由肥大细胞和嗜碱性细胞引发的最严重的急性全身和潜在威胁生命的反应。最近的研究表明，全球发病率为每100,000人年50至112例。最确定的触发因素是食物，药物,和昆虫毒液。我们旨在分析向瑞士大学成人急诊科就诊的患者的诱因和临床症状。
方法：对急诊科收治的所有中重度过敏反应（Ring和Messmer分类≥2）患者（>16岁）进行6年回顾性分析（2013年1月至2018年12月）。从急诊科的电子医疗数据库中提取患者和临床数据。
结果：在531名患者中，53.3%是女性，中位年龄为38[IQR26-51]岁.最常见的可疑触发因素是药物（31.8％），食物(25.6%),和昆虫叮咬(17.1%)。器官表现在不同的可疑触发因素中有所不同：对于药物，90.5%的患者有皮肤症状,其次是呼吸（62.7%），心血管症状（44.4%）和胃肠道症状（33.7%）；对于食物，胃肠道症状（39.7％）比心血管症状（36.8％）更常见，对于昆虫叮咬，心血管症状在63.8％的病例中明显。
结论：在16岁以上的受试者中，6年期间中度至重度过敏反应的年平均发生率为每100,000居民10.67。药物（抗生素，NSAID和放射性造影剂）是最常见的可疑触发因素。昆虫叮咬引起的过敏反应比其他研究更频繁。关于临床症状，胃肠道症状需要更好地考虑，尤其是肾上腺素的初始治疗不会延迟。
方法：对急诊科收治的所有中重度过敏反应（Ring和Messmer分类≥2）患者（>16岁）进行6年回顾性分析（2013年1月至2018年12月）。从急诊科的电子医疗数据库中提取患者和临床数据。
结果：在531名患者中，53.3%是女性，中位年龄为38[IQR26-51]岁.最常见的可疑触发因素是药物（31.8％），食物(25.6%),和昆虫叮咬(17.1%)。器官表现在不同的可疑触发因素中有所不同：对于药物，90.5%的患者有皮肤症状,其次是呼吸（62.7%），心血管症状（44.4%）和胃肠道症状（33.7%）；对于食物，胃肠道症状（39.7％）比心血管症状（36.8％）更常见，对于昆虫叮咬，心血管症状在63.8％的病例中明显。
结论：在16岁以上的受试者中，6年期间中度至重度过敏反应的年平均发生率为每100,000居民10.67。药物（抗生素，NSAID和放射性造影剂）是最常见的可疑触发因素。昆虫叮咬引起的过敏反应比其他研究更频繁。关于临床症状，胃肠道症状需要更好地考虑，尤其是肾上腺素的初始治疗不会延迟。
