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老年患者的过敏反应:一项为期10年的回顾性研究经验。

Anaphylaxis in older adult patients: a 10-year retrospective experience.

作者信息

Yıldız Eray, Arslan Şevket, Çölkesen Fatih, Evcen Recep, Sadi Aykan Filiz, Kılınç Mehmet

机构信息

Division of Clinical Immunology and Allergy, Department of Internal Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.

出版信息

World Allergy Organ J. 2022 Jul 14;15(7):100665. doi: 10.1016/j.waojou.2022.100665. eCollection 2022 Jul.

Abstract

BACKGROUND

Despite the worldwide increase in life expectancy and the elderly population, very little is known about the characteristics of anaphylaxis in older adults.

METHODS

A retrospective scan was made of the files of patients who presented at the Allergy Unit of our clinic between October 2011 and October 2021. The study included 971 patients aged ≥18 years who met the criteria for diagnosis of anaphylaxis. The patients were separated into 2 groups of adults (18-64 years) and older adults (≥65 years).

RESULTS

The adult group included 887 (91.3%) patients and the older adult group, 84 (8.7%) patients. Comorbid diseases were seen more frequently in the older adults than in the adult group (p < 0.001). Drugs were seen to be the most common trigger of anaphylaxis in both groups, and this was more common in the older adult group (p = 0.039). Food was a more common trigger of anaphylaxis in the adult group than in the older adult group (p = 0.017). In both groups, the skin was the organ most affected, and was less affected in the older adults than in the adults (p = 0.020). Cardiovascular symptoms were seen significantly more and respiratory symptoms significantly less in the older adult group (p < 0.001, p = 0.002, respectively). Admission to the hospital and the intensive care unit was more frequent in the older adult group and rates of adrenalin administration were higher compared to the adult group (p < 0.001 for all).

CONCLUSION

Anaphylaxis in the older adults is generally caused by drugs. Older adults were found to have more cardiovascular symptoms and more frequent adrenalin injections, hospitalizations and intensive care unit admissions.

摘要

背景

尽管全球预期寿命和老年人口有所增加,但对于老年人过敏反应的特征却知之甚少。

方法

对2011年10月至2021年10月期间在我们诊所过敏科就诊的患者档案进行回顾性扫描。该研究纳入了971名年龄≥18岁且符合过敏反应诊断标准的患者。将患者分为两组,成人组(18 - 64岁)和老年人组(≥65岁)。

结果

成人组包括887名(91.3%)患者,老年人组包括84名(8.7%)患者。老年人组的合并症比成人组更常见(p < 0.001)。两组中药物都是最常见的过敏反应诱因,且在老年人组中更常见(p = 0.039)。食物在成人组中是比老年人组更常见的过敏反应诱因(p = 0.017)。两组中皮肤都是受影响最严重的器官,且老年人组的皮肤受累程度低于成人组(p = 0.020)。老年人组心血管症状显著更多,而呼吸道症状显著更少(分别为p < 0.001,p = 0.002)。老年人组住院和入住重症监护病房的频率更高,肾上腺素给药率也高于成人组(所有p < 0.001)。

结论

老年人的过敏反应通常由药物引起。发现老年人有更多的心血管症状,肾上腺素注射、住院和入住重症监护病房的频率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce99/9293944/d6002b2c59a1/gr1.jpg

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