Tasmanian Health Service, Burnie, Tasmania, Australia.
Tasmanian School of Medicine, Rural Clinical School, University of Tasmanian, Burnie, Tasmania, Australia.
J Paediatr Child Health. 2022 Aug;58(8):1407-1413. doi: 10.1111/jpc.16006. Epub 2022 May 4.
Explore the prevalence of childhood anaphylaxis and clinical presentation of anaphylaxis in children across two regional emergency departments over a 7-year period.
Retrospective audit of all children (0-18 years) presenting to emergency from 1 January 2010 to 31 December 2016 with anaphylaxis, defined by Australasian Society of Clinical Immunology and Allergy definitions and doctor diagnosis.
Seven hundred and twenty-four patients were identified with allergic diagnosis, 60% were diagnosed with non-anaphylaxis allergic reactions or unspecified urticaria and 40% with anaphylaxis (n = 286). Annual prevalence of anaphylaxis remained stable over the study period (M = 30.9/10 000 cases, range: 20.8-48.3/10 000). Gender distribution was equal, median age was 9.48 years (interquartile range = 4-15). Most (71%) arrived by private transport. 23% had a prior history of anaphylaxis. Food triggers (44%) were the most common cause of anaphylaxis. Insect bites/stings triggers occurred in 21%. Patients were promptly assessed (average wait time = 13 min), 16% received prior adrenaline injections. Adrenaline was administered in 26% and 20% were admitted to hospital. On discharge, 29% had a follow-up plan, 9% received an allergy clinic referral, 6% anaphylaxis action plan, 26% adrenaline autoinjector prescriptions and allergy testing performed in 6%.
We found a relatively low prevalence of overall childhood anaphylaxis in a regional area. The two most common causes of anaphylaxis in this population (food and bites/stings) recorded increased prevalence providing an opportunity for further study. Significant gaps in evidence-based care of anaphylaxis were noted, demonstrating the need for improved recognition and treatment guideline implementation in regional areas.
探讨在 7 年期间，两个地区急诊部门中儿童过敏反应和过敏反应临床特征的流行情况。
回顾性分析 2010 年 1 月 1 日至 2016 年 12 月 31 日期间因过敏反应（根据澳大拉西亚临床免疫学和过敏学会的定义和医生诊断）到急诊就诊的所有（0-18 岁）儿童患者的病历。
共发现 724 例有过敏诊断的患者，其中 60%被诊断为非过敏反应性过敏反应或未明确的荨麻疹，40%被诊断为过敏反应（n=286）。在研究期间，过敏反应的年患病率保持稳定（M=30.9/10000 例，范围：20.8-48.3/10000）。性别分布均衡，中位年龄为 9.48 岁（四分位距=4-15）。大多数（71%）是通过私人交通工具到达的。23%有过敏反应的既往史。食物触发（44%）是过敏反应最常见的原因。昆虫叮咬/蜇伤占 21%。患者得到了及时评估（平均等待时间=13 分钟），16%的患者接受了肾上腺素注射。26%的患者给予肾上腺素，20%的患者住院治疗。出院时，29%的患者有随访计划，9%的患者接受过敏诊所转诊，6%的患者接受过敏反应行动计划，26%的患者开了肾上腺素自动注射器处方，6%的患者进行了过敏测试。
我们发现一个地区儿童过敏反应的总体患病率相对较低。在该人群中，过敏反应的两个最常见原因（食物和叮咬/蜇伤）的患病率有所增加，这为进一步研究提供了机会。在过敏反应的循证治疗方面存在显著差距，这表明需要在地区层面提高对过敏反应的认识和治疗指南的实施。
