RT Journal Article
T1 Risk Factors for Severe Anaphylaxis in Children
A1 Olabarri, Mikel
A1 Vázquez López, Paula
A1 González Posada, Aranzazu
A1 Sanz, Nuria
A1 González Peris, Sebastià
A1 Diez, Nuria
A1 Vinuesa, Ana
A1 Martínez Indart, Lorea
A1 Benito, Javier
A1 Mintegi, Santiago
AB Objective: To identify risk factors associated with severe anaphylaxis in children.Study design: We carried out a multicenter prospective observational study including children less than 18 years old diagnosed with anaphylaxis in 7 Spanish pediatric emergency departments (EDs) between May 2016 and April 2018. Children were considered to have severe anaphylaxis if they met one or more of the following criteria: requirement for 2 or more doses of epinephrine, clinically important biphasic reaction, endotracheal intubation, intensive care unit admission, and/or death.Results: We included 453 episodes of anaphylaxis. Of these, 61 were classified as severe anaphylaxis (13.5%, 95% CI [10.6-16.9]): 53 (11.7%) required more than 1 dose of epinephrine, and there were 14 (3.1%) cases of clinically important biphasic reactions, 2 (0.4%) intubations in the ED, and 6 (1.3%) admissions to the intensive care unit. No patients died. In the multivariable regression, we identified 5 independent risk factors for severe anaphylaxis: history of asthma (P = .002; OR 2.705, 95% CI [1.431-5.113]), onset of the symptoms less than 5 minutes after the allergen exposure (P = .002; OR 2.619, 95% CI [1.410-4.866]), non-well appearance (P = .005; OR 2.973, 95% CI [1.380-6.405]), tachycardia (P = .014; OR 2.339, 95% CI [1.191-4.959]), and hypotension (P = .036; OR 3.725, 95% CI [1.087-12.762]).Conclusions: Childhood anaphylaxis is usually well controlled in the ED. Children with a history of asthma, rapid onset of the symptoms, who are non-well appearing, or have tachycardia or hypotension upon arrival to the ED are more likely to have severe episodes.
PB Elsevier
SN 0022-3476
YR 2020
FD 2020-10-02
LK https://hdl.handle.net/20.500.14352/116168
UL https://hdl.handle.net/20.500.14352/116168
LA eng
NO Olabarri M, Vazquez P, Gonzalez-Posada A, Sanz N, Gonzalez-Peris S, Diez N, Vinuesa A, Martinez-Indart L, Benito J, Mintegi S, Risk Factors for Severe Anaphylaxis in Children, The Journal of Pediatrics (2020), doi: https://doi.org/10.1016/j.jpeds.2020.06.021.
DS Docta Complutense
RD 13 abr 2025