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Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions
P M Hopkins1, P J Cooke2, R C Clarke3
1Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Anaesthetic Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
British Journal of Anaesthesia
|April 29, 2019
Summary
A new clinical scoring system helps determine the likelihood of immediate hypersensitivity reactions during surgery. This tool aids in evaluating diagnostic tests for perioperative allergy and identifying specific triggers.
Area of Science:
- Anesthesiology
- Allergy and Immunology
- Clinical Diagnostics
Background:
- Existing grading schemes lack specificity for perioperative allergic reactions.
- A validated scoring system is needed to assess diagnostic tests for immediate hypersensitivity reactions in the surgical setting.
Framework:
- Development of a clinical scoring system using a Delphi consensus process.
- Involved 25 international multidisciplinary experts in perioperative allergy.
- Utilized expert ratings and clinical scenarios to refine the scoring system.
Implementation:
- Two rounds of Delphi process achieved consensus on 43 of 60 initial statements.
- Statements rated for appropriateness (median score ≥7) and agreement (disagreement index <0.5).
- Scoring system validated against expert ratings of clinical scenarios; supplementary mast cell tryptase scores included.
Implications:
- Provides an objective and uniform method for assessing suspected perioperative immediate hypersensitivity reactions.
- Facilitates more accurate evaluation of diagnostic tests for perioperative allergy.
- Aims to improve diagnostic accuracy and patient management in surgical allergic reactions.
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