Gaeta Theodore J, Clark Sunday, Pelletier Andrea J, Camargo Carlos A
New York Methodist Hospital, Brooklyn, New York, USA.
Ann Allergy Asthma Immunol. 2007 Apr;98(4):360-5. doi: 10.1016/S1081-1206(10)60883-6.
The clinical epidemiology of acute allergic reactions in the emergency department (ED) is uncertain.
To characterize ED visits for acute allergic reactions and to evaluate national trends in ED management.
The National Hospital Ambulatory Medical Care Survey was used to identify a nationally representative sample of ED visits between 1993 and 2004. Cases with a diagnosis of acute allergic reaction were identified by International Classification of Diseases, Ninth Revision (ICD-9) codes (9950, 9951, 9952, 9953, 9956).
A total of 12.4 million allergy-related ED visits occurred from 1993 to 2004, representing 1.0% (95% confidence interval, 0.93%-1.10%) of all ED visits or 1.03 million ED visits per year. The number of allergy-related ED visits remained relatively stable, averaging 3.8 per 1,000 US population per year (95% confidence interval, 3.4-4.1; P for trend = .39). Although 63% of all visits were coded as urgent, only 4% required hospitalization. Anaphylaxis coding was rare (1%). ED staff prescribed medications in 87% of visits, especially histamine, blockers (62%; P for trend = .29). Increases were noted from 1993 to 2004 for corticosteroids (22% to 50%; P < .001), histamine2 blockers (7% to 18%; P < .001), and inhaled beta-agonists (2% to 6%; P = .008). Epinephrine use was infrequent and declining (19% to 7%; P = .04).
Between 1993 and 2004, significant variability has occurred in ED management of acute allergic reactions.
急诊科急性过敏反应的临床流行病学尚不确定。
描述急性过敏反应的急诊科就诊情况，并评估急诊科管理的全国趋势。
使用国家医院门诊医疗调查来确定1993年至2004年间具有全国代表性的急诊科就诊样本。通过国际疾病分类第九版（ICD-9）编码（9950、9951、9952、9953、9956）确定诊断为急性过敏反应的病例。
1993年至2004年期间，共有1240万次与过敏相关的急诊科就诊，占所有急诊科就诊的1.0%（95%置信区间，0.93%-1.10%），即每年103万次急诊科就诊。与过敏相关的急诊科就诊次数保持相对稳定，平均每年每1000名美国人口中有3.8次（95%置信区间，3.4-4.1；趋势P值=.39）。虽然所有就诊中有63%被编码为紧急情况，但只有4%需要住院治疗。过敏反应编码很少见（1%）。急诊科工作人员在87%的就诊中开了药，尤其是组胺阻滞剂（62%；趋势P值=.29）。1993年至2004年期间，皮质类固醇（22%至50%；P<.001）、组胺2阻滞剂（7%至18%；P<.001）和吸入性β激动剂（2%至6%；P=.008）的使用有所增加。肾上腺素的使用很少且呈下降趋势（19%至7%；P=.04）。
1993年至2004年期间，急诊科对急性过敏反应的管理出现了显著变化。
