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Risk Factors for Severe Anaphylaxis in Children
Mikel Olabarri1, Paula Vazquez2, Aranzazu Gonzalez-Posada3
1Pediatric Emergency Department, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, UPV/EHU. Bilbao, Basque Country, Spain.
The Journal of Pediatrics
|June 17, 2020
Summary
Children with asthma, rapid symptom onset, or signs of poor appearance, tachycardia, or hypotension are at higher risk for severe childhood anaphylaxis. Early recognition of these factors is crucial for prompt management in emergency departments.
Area of Science:
- Pediatric Emergency Medicine
- Allergy and Immunology
- Clinical Risk Factor Analysis
Background:
- Anaphylaxis is a severe allergic reaction that can be life-threatening.
- Identifying risk factors for severe anaphylaxis in children is critical for timely and effective management.
Purpose of the Study:
- To identify independent risk factors associated with severe anaphylaxis in pediatric patients.
Main Methods:
- A multicenter prospective observational study was conducted in 7 Spanish pediatric emergency departments.
- 453 episodes of anaphylaxis in children under 18 years old were analyzed.
- Severe anaphylaxis was defined by criteria including multiple epinephrine doses, biphasic reactions, intubation, ICU admission, or death.
Main Results:
- Of 453 anaphylaxis episodes, 13.5% were classified as severe.
- Independent risk factors for severe anaphylaxis included a history of asthma (OR 2.705), symptom onset <5 minutes post-exposure (OR 2.619), non-well appearance (OR 2.973), tachycardia (OR 2.339), and hypotension (OR 3.725).
- No deaths were reported; however, severe cases required significant medical intervention.
Conclusions:
- Childhood anaphylaxis is generally well-managed in emergency departments.
- Asthma history, rapid symptom onset, non-well appearance, tachycardia, and hypotension are key indicators of potential severe pediatric anaphylaxis episodes.
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