Paediatric emergency department anaphylaxis: different patterns from adults
Paediatric emergency department anaphylaxis: different patterns from adults
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DOI：
10.1136/adc.2004.069914
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发表时间：
2006-02-01
影响因子：
5.2
通讯作者：
Brown, AFT
中科院分区：
文献类型：
--
作者：
Braganza, SC;Acworth, JP;Brown, AFT
背景和目的：急诊科（艾德）急性儿科过敏反应报告的数据有限。所有过敏介绍一个澳大利亚儿科艾德进行了研究，以确定流行病学，临床和结果data.Methods：回顾性，病例为基础的研究，16岁以下的患者参加一个大都市，儿科教学医院艾德在澳大利亚超过三年。研究了符合相关ICD-9-CM诊断代码的全身过敏反应和速发型过敏反应患者的病历。发病率，年龄，性别比，共病，可能的病因，临床特点，管理，处置determined.Results：共526名儿童全身过敏反应，57过敏反应被列入研究。这表示全身性过敏反应的艾德发生率为9.3：1000，速发过敏反应的发生率为1：1000。无人死亡。在过敏性反应病例中，68.4%的病例确认了原因。82.5%有皮肤特征。36.8%的患者报告有哮喘既往史。39.3%的严重过敏反应病例使用了肾上腺素。艾德单独明确照顾了97.8%的患者。后续是不充分的情况下，过敏性反应。结论：这是第一次报告的发病率数字儿科过敏性反应艾德介绍在澳大利亚，是小于成人报告在同一当地人口。然而，全身过敏反应的发生率为9.3：1000，高于成人。事实上，只要认识到专家随访的重要性，特别是对于重度过敏反应，所有儿科过敏病例都可以在艾德单独管理。
Background and Aims: Data on acute paediatric anaphylaxis presentations to the emergency department (ED) are limited. All allergic presentations to one Australian paediatric ED were studied to determine epidemiological, clinical, and outcome data.Methods: Retrospective, case based study of patients under 16 years attending one metropolitan, paediatric teaching hospital ED in Australia over three years. The medical records of patients presenting with generalised allergic reactions and anaphylaxis satisfying relevant ICD-9-CM diagnostic codes were studied. The incidence, age, sex ratio, co-morbidities, likely aetiology, clinical features, management, and disposal were determined.Results: A total of 526 children with generalised allergic reactions, and 57 with anaphylaxis were included in the study. This represented incidences of 9.3: 1000 ED presentations for generalised allergic reactions and 1: 1000 for anaphylaxis. There were no fatalities. In anaphylaxis cases, a cause was recognised in 68.4%. Cutaneous features were present in 82.5%. A past history of asthma was reported in 36.8%. Adrenaline was used in 39.3% of severe anaphylaxis cases. The ED alone definitively cared for 97.8% of all patients. Follow up was inadequate in cases of anaphylaxis.Conclusions: This is the first reported incidence figure for paediatric anaphylaxis ED presentations in Australia, and is less than that reported in adults in the same local population. However, the incidence of generalised allergic reactions of 9.3: 1000 was greater than in the adults. Virtually all paediatric allergic cases may be managed in the ED alone, provided that the importance of specialist follow up, particularly for severe anaphylaxis, is recognised.