Kodoth Sangeetha Mohan, Alves Paulo, Convers Kathryn, Davis Karla, Chang Christopher
Allergy Specialists of Knoxville, Knoxville, Tennessee.
MedAire, an International SOS company, Phoenix, Arizona.
Ann Allergy Asthma Immunol. 2023 Jan;130(1):74-79. doi: 10.1016/j.anai.2022.08.004. Epub 2022 Aug 15.
Allergic reactions account for 2% to 4% of medical events in-flight and 5.5% of all medical events in passengers 18 years and under.
To evaluate the incidence of in-flight allergic events including availability, use of epinephrine, and final patient outcome.
We conducted a retrospective study of the ground-based medical service (GBMS) database from January 2017 to December 2019 for all allergic events and epinephrine utilization.
A total of 140,579 in-flight medical events (IFMEs) were initially retrieved from the period between January, 2017 and December, 2019, of which 4230 (3.0%) unique cases were identified as allergic events. Epinephrine administration was recommended in 398 passengers by GBMS. Of those, 328 (82.4%) ultimately received at least 1 dose of epinephrine. In multivariate analysis, there was a significant difference in the involvement of volunteers (odds ratio [OR], 3.19; P value < .001; 95% confidence interval [CI], 2.43-4.16), availability of autoinjectors (OR, 2; P value < .001; 95% CI, 1.55-2.58), flight diversion (OR, 11.21; P value < .001; 95% CI, 3.60-34.89), and hospital transport (OR, 6.58; P value < .001; 95% CI, 4.62-9.38) between the 2 groups. Passengers older than 12 years of age were at a higher risk for epinephrine administration. In the secondary analysis of 51 airlines that consistently use GBMS for all IFMEs, the incidence of allergic events was found to be 0.91 cases per million passengers. The incidence of severe in-flight allergic emergencies requiring epinephrine administration was 0.08 cases per million passengers or 12.5 million passengers for 1 event.
IFME requiring epinephrine administration is rare with an incidence rate of 1 event in 12.5 million passengers. The risk for epinephrine administration is higher in passengers more than 12 years of age and is associated with significantly higher flight diversion, hospital transport, and involvement of medical volunteers.
过敏反应占飞行中医疗事件的2%至4%，在18岁及以下乘客的所有医疗事件中占5.5%。
评估飞行中过敏事件的发生率，包括肾上腺素的可获得性、使用情况以及患者最终结局。
我们对2017年1月至2019年12月地面医疗服务（GBMS）数据库中所有过敏事件和肾上腺素使用情况进行了回顾性研究。
最初从2017年1月至2019年12月期间检索到总共140579起飞行中医疗事件（IFME），其中4230例（3.0%）独特病例被确定为过敏事件。GBMS建议398名乘客使用肾上腺素。其中，328名（82.4%）最终至少接受了1剂肾上腺素。在多变量分析中，两组在志愿者参与情况（优势比[OR]，3.19；P值<.001；95%置信区间[CI]，2.43 - 4.16）、自动注射器的可获得性（OR，2；P值<.001；95%CI，1.55 - 2.58）、航班改道（OR，11.21；P值<.001；95%CI，3.60 - 34.89）和医院转运（OR，6.58；P值<.001；95%CI，4.62 - 9.38）方面存在显著差异。12岁以上乘客使用肾上腺素的风险更高。在对51家始终将GBMS用于所有IFME的航空公司的二次分析中，发现过敏事件的发生率为每百万乘客0.91例。需要使用肾上腺素的严重飞行中过敏紧急情况的发生率为每百万乘客0.08例，即1起事件对应1250万乘客。
需要使用肾上腺素的IFME很少见，发生率为每1250万乘客1起事件。12岁以上乘客使用肾上腺素的风险更高，且与显著更高的航班改道、医院转运以及医疗志愿者的参与相关。
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