Ichikawa Motohiro, Kuriyama Akira, Urushidani Seigo, Ikegami Tetsunori
Emergency and Critical Care Center Kurashiki Central Hospital Okayama Japan.
Acute Med Surg. 2021 Jul 30;8(1):e689. doi: 10.1002/ams2.689. eCollection 2021 Jan-Dec.
We investigated the frequency of overall biphasic reactions, biphasic reactions that met the diagnostic criteria of anaphylaxis, and biphasic reactions that caused a severe abnormality in vital signs in patients who visited the emergency department of a tertiary hospital.
This retrospective cohort study included patients aged 18 years or over who presented with anaphylaxis at the emergency department of a tertiary care hospital between January 2014 and December 2016. The primary outcome was the incidence of biphasic reactions that caused a severe abnormality in vital signs and developed within 7 days. Secondary outcomes were the frequency of overall biphasic reactions and those that met the diagnostic criteria of anaphylaxis.
In total, 437 patients aged over 18 years visited the emergency department during the study period. Among them, 202 were enrolled in this study. The proportion of patients who had overall biphasic reactions, those that met the diagnostic criteria of anaphylaxis, and those with a severe abnormality in vital signs was 8.9%, 3.0%, and 1.0%, respectively. Overall, 32.7% of patients were hospitalized, but hospitalization aided in the treatment of severe biphasic reactions at the early stage in only one patient.
We found that 8.9% of adult patients with anaphylaxis had a biphasic reaction, but biphasic reactions together with severe abnormalities in vital signs were rare.
我们调查了在一家三级医院急诊科就诊的患者中，全身性双相反应、符合过敏反应诊断标准的双相反应以及导致生命体征严重异常的双相反应的发生频率。
这项回顾性队列研究纳入了2014年1月至2016年12月期间在一家三级护理医院急诊科出现过敏反应的18岁及以上患者。主要结局是在7天内发生且导致生命体征严重异常的双相反应的发生率。次要结局是全身性双相反应以及符合过敏反应诊断标准的双相反应的发生频率。
在研究期间，共有437名18岁以上患者前往急诊科就诊。其中，202名患者被纳入本研究。发生全身性双相反应、符合过敏反应诊断标准的双相反应以及生命体征严重异常的患者比例分别为8.9%、3.0%和1.0%。总体而言，32.7%的患者住院治疗，但住院仅对一名患者的早期严重双相反应治疗有帮助。
我们发现，8.9%的成年过敏反应患者出现了双相反应，但伴有生命体征严重异常的双相反应很少见。
