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J Korean Soc Emerg Med > Volume 34(1); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(1): 79-86.
아나필락시스의 임상양상과 중증 아나필락시스와 연관된 위험인자
김성우1 , 진영호1,2 , 정태오1,2 , 윤재철1,2 , 김소은1,2 , 오태환1 , 김상민1 , 이재백1,2
1전북대학교병원 응급의학과
2전북대학교 의과대학 응급의학교실
Clinical features of anaphylaxis and risk factors of severe anaphylaxis in the emergency department
Seong Woo Kim1 , Young Ho Jin1,2 , Tae Oh Jeong1,2 , Jae Chol Yoon1,2 , So Eun Kim1,2 , Tae Hwan Oh1 , Sang Min Kim1 , Jae Baek Lee1,2
1Department of Emergency Medicine, Jeonbuk National University Hospital, Jeonju, Korea
2Department of Emergency Medicine, Jeonbuk National University Medical School, Jeonju, Korea
Correspondence  Jae Baek Lee ,Tel: 063-250-1075, Email: baeklee@jbnu.ac.kr,
Received: February 18, 2022; Revised: August 20, 2022   Accepted: September 11, 2022.  Published online: February 28, 2023.
This study investigates the triggers and clinical features of anaphylaxis, and determines the risk factors associated with severe anaphylaxis.
This is a retrospective observational study spanning a duration of 2 years (2020-2021) using the electronic data of patients diagnosed with anaphylaxis in the university-affiliated emergency center. Severe anaphylaxis was defined as refractory anaphylaxis requiring ≥3 times epinephrine administration and/or continuous epinephrine infusion. Baseline and clinical characteristics were compared between the severe and the non-severe anaphylaxis groups. Binary logistic regression analysis was performed to reveal independent risk factors associated with severe anaphylaxis.
The median age of study patients was determined to be 53.0 years (range, 37.5-65.0 years). Fifty-eight patients (58.0%) were male. Drugs were found to be the most common trigger. In clinical manifestations, cutaneous manifestation was the most common. Severe anaphylaxis occurred in 19 patients (19.0%). Latent time was shorter in the severe anaphylaxis group-10.0 minutes (5.0-20.0) vs. 30.0 minutes (10.0-60.0), P<0.001. Drug as a trigger (68.4% vs. 39.5%, P=0.023), hypotension (57.9% vs. 9.9%, P<0.001), cardiovascular manifestation (84.2% vs. 40.7%, P=0.001), and hyperlactatemia (73.7% vs. 46.9%, P=0.036) were more frequently observed in the severe anaphylaxis group. Shorter latent time, drug as a trigger, and presence of hypotension were independent risk factors for severe anaphylaxis.
Anaphylaxis patients with shorter latent time, diagnosed with drugs as a trigger, and presenting with hypotension, must be subjected to careful monitoring and early active treatment.
Key words: Allergy; Precipitating factors; Shock; Epidemiology
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