Abstract：
BACKGROUND: Perioperative anaphylaxis is a serious and often life-threatening immediate hypersensitivity reaction. There are few published data on paediatric perioperative anaphylaxis (pPOA). We evaluated the incidence of and risk factors involved in the occurrence of pPOA within a large US national database.
METHODS: Deidentified data from the US Nationwide Inpatient Sample from 2005 to 2014 were used to identify pPOA cases and to conduct a retrospective multivariate analysis of preselected independent variables.
RESULTS: Among 3,601,180 surgeries and procedures in children aged 0-18 yr, 297 pPOA cases were identified for an incidence of one in 12,125 surgeries and procedures. Compared with controls, pPOA cases had an increased median length of stay (6 vs 2 days; P<0.001) and median hospital cost ($54 719 vs $5109; P<0.0001). The age groups between 6 and 12 yr (odds ratio [OR] 7.1; 95% confidence interval [CI] 3.9-12.9; P<0.001) and 13 and 17 yr (OR 8.5; 95% CI 4.7-15.2; P<0.001) were associated with increased odds of pPOA. Transplant (OR 46.3; 95% CI 20.8-102.9; P<0.001), cardiac (OR 16.4; 95% CI 7.5-35.9; P<0.001), and vascular (OR 15.2; 95% CI 7.5-30.7; P<0.001) procedures posed the highest risk for pPOA. Chronic pulmonary disease, coagulopathy, and fluid and electrolyte disorders were also associated with pPOA (OR 2.2; 95% CI 1.5-3.3; P<0.001).
CONCLUSIONS: The incidence of pPOA was one in 12,125 cases. Risk factors included age, procedure type, and comorbidities.
METHODS: Deidentified data from the US Nationwide Inpatient Sample from 2005 to 2014 were used to identify pPOA cases and to conduct a retrospective multivariate analysis of preselected independent variables.
RESULTS: Among 3,601,180 surgeries and procedures in children aged 0-18 yr, 297 pPOA cases were identified for an incidence of one in 12,125 surgeries and procedures. Compared with controls, pPOA cases had an increased median length of stay (6 vs 2 days; P<0.001) and median hospital cost ($54 719 vs $5109; P<0.0001). The age groups between 6 and 12 yr (odds ratio [OR] 7.1; 95% confidence interval [CI] 3.9-12.9; P<0.001) and 13 and 17 yr (OR 8.5; 95% CI 4.7-15.2; P<0.001) were associated with increased odds of pPOA. Transplant (OR 46.3; 95% CI 20.8-102.9; P<0.001), cardiac (OR 16.4; 95% CI 7.5-35.9; P<0.001), and vascular (OR 15.2; 95% CI 7.5-30.7; P<0.001) procedures posed the highest risk for pPOA. Chronic pulmonary disease, coagulopathy, and fluid and electrolyte disorders were also associated with pPOA (OR 2.2; 95% CI 1.5-3.3; P<0.001).
CONCLUSIONS: The incidence of pPOA was one in 12,125 cases. Risk factors included age, procedure type, and comorbidities.
摘要：
背景：围手术期过敏反应是一种严重且经常危及生命的即时超敏反应。关于小儿围手术期过敏反应（pPOA）的公开数据很少。我们在美国大型国家数据库中评估了pPOA的发生率和危险因素。
方法：使用2005年至2014年美国全国住院患者样本的鉴定数据来识别pPOA病例，并对预选的自变量进行回顾性多变量分析。
结果：在0-18岁儿童的3,601,180例手术和程序中，在12,125例手术和程序中确定了297例pPOA的发生率。与对照组相比，pPOA病例的中位住院时间（6天vs2天；P<0.001）和中位住院费用（$54719vs$5109；P<0.0001）增加。6-12岁年龄组(比值比[OR]7.1;95%置信区间[CI]3.9-12.9;P<0.001)和13-17岁年龄组(OR8.5;95%CI4.7-15.2;P<0.001)与pPOA比值增加相关。移植（OR46.3；95%CI20.8-102.9；P<0.001），心脏（OR16.4；95%CI7.5-35.9；P<0.001），和血管（OR15.2;95％CI7.5-30.7;P<0.001）的手术构成pPOA的最高风险。慢性肺病,凝血病,液体和电解质紊乱也与pPOA相关(OR2.2;95%CI1.5-3.3;P<0.001)。
结论：pPOA的发生率为12,125例中的1例。危险因素包括年龄、程序类型,和合并症。
方法：使用2005年至2014年美国全国住院患者样本的鉴定数据来识别pPOA病例，并对预选的自变量进行回顾性多变量分析。
结果：在0-18岁儿童的3,601,180例手术和程序中，在12,125例手术和程序中确定了297例pPOA的发生率。与对照组相比，pPOA病例的中位住院时间（6天vs2天；P<0.001）和中位住院费用（$54719vs$5109；P<0.0001）增加。6-12岁年龄组(比值比[OR]7.1;95%置信区间[CI]3.9-12.9;P<0.001)和13-17岁年龄组(OR8.5;95%CI4.7-15.2;P<0.001)与pPOA比值增加相关。移植（OR46.3；95%CI20.8-102.9；P<0.001），心脏（OR16.4；95%CI7.5-35.9；P<0.001），和血管（OR15.2;95％CI7.5-30.7;P<0.001）的手术构成pPOA的最高风险。慢性肺病,凝血病,液体和电解质紊乱也与pPOA相关(OR2.2;95%CI1.5-3.3;P<0.001)。
结论：pPOA的发生率为12,125例中的1例。危险因素包括年龄、程序类型,和合并症。
