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Published on: April 21, 2019
Inpatient allergy/immunology consultations in a tertiary care setting
Hans F Otto1, Ronald W England, James M Quinn
1Department of Allergy and Immunology, Wright Patterson Medical Center, Wright-Patterson Air Force Base, Dayton, Ohio 45433, USA. hans.otto@wpafb.af.mil
Allergy and Asthma Proceedings
|July 10, 2010
Summary
Inpatient allergy/immunology (AI) consults have declined, with fewer asthma cases but more evaluations for immunodeficiency and urticaria. Following AI recommendations improves patient outcomes.
Area of Science:
- Clinical Medicine
- Immunology
- Healthcare Management
Background:
- Limited research exists on inpatient allergy/immunology (AI) referral patterns.
- No comprehensive analysis of AI inpatient consultations has been published since 2003.
Purpose of the Study:
- To analyze trends in inpatient AI consultations over a 20-year period.
- To identify the primary reasons for AI consultations and associated diagnoses and outcomes.
Main Methods:
- Retrospective review of 254 inpatient AI consultations from July 2001 to June 2007.
- Combined data with a previous 14-year study for a 20-year trend analysis.
- Analyzed consultation reasons, diagnoses, and outcomes, including adherence to AI recommendations.
Main Results:
- A significant decline in AI inpatient consults was observed over the recent 6-year period (p = 0.0023).
- Over 20 years, inpatient asthma consults decreased by 85% (p < 0.00001), while evaluations for immunodeficiency, rash, and urticaria/angioedema increased (p < 0.05).
- Adverse drug reactions (ADRs) constituted 36% of consults, followed by urticaria/angioedema (17%) and immunodeficiency (13%).
Conclusions:
- Inpatient AI consultations have decreased, particularly for asthma, despite stable hospital admissions.
- Evaluations for immunodeficiency, rash, and urticaria/angioedema have increased.
- Adherence to AI recommendations is linked to improved patient clinical status, with a 16.6 odds ratio for better outcomes.
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