Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Allergy Clin Immunol. 2021 Jul;148(1):173-181. doi: 10.1016/j.jaci.2021.01.003. Epub 2021 Jan 19.
There is no widely adopted severity grading system for acute allergic reactions, including anaphylactic and nonanaphylactic reactions, thus limiting the ability to optimize and standardize management practices and advance research.
The aim of this study was to develop a severity grading system for acute allergic reactions for use in clinical care and research.
From May to September 2020, we convened a 21-member multidisciplinary panel of allergy and emergency care experts; 9 members formed a writing group to critically appraise and assess the strengths and limitations of prior severity grading systems and develop the structure and content for an optimal severity grading system. The entire study panel then revised the grading system and sought consensus by utilizing Delphi methodology.
The writing group recommended that an optimal grading system encompass the severity of acute allergic reactions on a continuum from mild allergic reactions to anaphylactic shock. Additionally, the severity grading system must be able to discriminate between clinically important differences in reaction severity to be relevant in research while also being intuitive and straightforward to apply in clinical care. Consensus was reached for all elements of the proposed severity grading system.
We developed a consensus severity grading system for acute allergic reactions, including anaphylactic and nonanaphylactic reactions. Successful international validation, refinement, dissemination, and application of the grading system will improve communication among providers and patients about the severity of allergic reactions and will help advance future research.
目前尚无广泛应用的急性过敏反应（包括过敏反应和非过敏反应）严重程度分级系统，这限制了管理实践的优化和标准化，并阻碍了相关研究的进展。
本研究旨在为临床和研究制定急性过敏反应严重程度分级系统。
2020 年 5 月至 9 月，我们召集了一个由 21 名过敏和急救护理专家组成的多学科小组；其中 9 名成员组成一个写作小组，批判性地评估和评估先前的严重程度分级系统的优缺点，并制定最佳严重程度分级系统的结构和内容。然后，全体研究小组成员利用德尔菲法修订分级系统并达成共识。
写作小组建议，一个理想的分级系统应涵盖从轻度过敏反应到过敏性休克的急性过敏反应的严重程度连续谱。此外，该严重程度分级系统必须能够区分临床反应严重程度的重要差异，以便在研究中具有相关性，同时在临床护理中具有直观和直接的应用。所有提议的严重程度分级系统的要素都达成了共识。
我们制定了一个急性过敏反应（包括过敏反应和非过敏反应）的共识严重程度分级系统。该分级系统的成功国际验证、细化、传播和应用将改善提供者和患者之间关于过敏反应严重程度的沟通，并有助于推进未来的研究。
