Allergic reactions after Hymenoptera stings in older adults: A multi-center study

Hymenoptera stings can cause severe allergic and systemic reactions, particularly in older adults. This study aimed to identify the risk factors associated with hospitalization after Hymenoptera stings, focusing on older adult patients.

A retrospective analysis was conducted across three hospitals in northern Taiwan, including 304 patients, from April 2021 to February 2023. Patients were divided into older (≥65 years) and younger (<65 years) adult groups. The clinical data, sting characteristics, and outcomes were analyzed.

Older adult patients were more likely to experience multiple sting sites (20.8 % vs. 10.3 %, p = 0.02) and stings on the head (48.6 % vs. 32.8 %, p = 0.02) and upper limbs (63.9 % vs. 42.7 %, p = 0.002) than younger patients. They had slower heart rates (85.7 vs. 92.4 bpm, p = 0.003) and higher creatinine kinase (CK) levels (1343.3 vs. 239.5 U/L, p = 0.003). Logistic regression identified three or more stings (odds ratio [OR]: 35.87, p = 0.002) or sting sites (OR: 35.2, p = 0.002) as significant predictors of hospitalization.

Older adult patients are at a higher risk of severe systemic reactions due to multiple Hymenoptera stings and elevated CK levels. Prompt assessment and monitoring are essential, particularly when patients present with multiple stings or sting sites, to reduce the risk of complications, such as acute kidney injury.