Caballero-Segura Francisco J, Cuadrado-Corrales Natividad, Jimenez-Garcia Rodrigo, Lopez-de-Andres Ana, Carabantes-Alarcon David, Zamorano-Leon Jose J, Carricondo Francisco, Romero-Gomez Barbara, De-Miguel-Díez Javier
Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain.
Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Healthcare (Basel). 2023 Nov 22;11(23):3016. doi: 10.3390/healthcare11233016.
(1) Background: Anaphylaxis is a rapid-onset, life-threatening hypersensitivity reaction. This study explores the epidemiological trends and clinical outcomes of adult patients with and without asthma hospitalized for anaphylaxis in Spain from 2016 to 2021. (2) Methods: Data from the Spanish National Hospital Discharge Database (RAE-CMBD) were analyzed. We stratified patients with anaphylaxis based on their asthma diagnosis and evaluated various comorbidities and clinical outcomes. Propensity score matching was used to match confounders. (3) Results: The total number of hospitalizations for anaphylaxis remained stable, with a decrease in 2020 probably due to the COVID-19 pandemic. Drug-induced anaphylaxis increased, in addition to being the main triggering factor. Asthma prevalence among those admitted for anaphylaxis emerged from 7.63% to 10.69%, with a higher frequency of respiratory failure and need for mechanical ventilation in this group; despite this, ICU admissions and in-hospital mortality did not differ significantly between asthmatics and non-asthmatics. Asthma was also not a risk factor for severe anaphylaxis. Multivariable analysis identified advanced age, ischemic heart disease, acute respiratory failure, and invasive mechanical ventilation as factors associated with severe anaphylaxis. (4) Conclusions: This study provides valuable information on the complexity of anaphylaxis, its relationship with asthma, and factors influencing its severity. Overall, clinical outcomes did not differ significantly in asthmatic patients compared to non-asthmatic patients, although asthmatic patients had more respiratory complications. Further research is necessary to delve deeper into the multifactorial nature of anaphylaxis and its implications in clinical practice.
(1)背景:过敏反应是一种起病迅速、危及生命的超敏反应。本研究探讨了2016年至2021年在西班牙因过敏反应住院的成年哮喘患者和非哮喘患者的流行病学趋势及临床结局。(2)方法:分析了西班牙国家医院出院数据库(RAE-CMBD)的数据。我们根据哮喘诊断对过敏反应患者进行分层,并评估了各种合并症和临床结局。采用倾向评分匹配法来匹配混杂因素。(3)结果:过敏反应的住院总数保持稳定,2020年有所下降,可能是由于新冠疫情。除了是主要触发因素外,药物引起的过敏反应有所增加。因过敏反应入院患者中的哮喘患病率从7.63%升至10.69%,该组呼吸衰竭和需要机械通气的频率更高;尽管如此,哮喘患者和非哮喘患者在重症监护病房入院率和院内死亡率方面并无显著差异。哮喘也不是严重过敏反应的危险因素。多变量分析确定高龄、缺血性心脏病、急性呼吸衰竭和有创机械通气是与严重过敏反应相关的因素。(4)结论:本研究提供了关于过敏反应的复杂性、其与哮喘的关系以及影响其严重程度的因素的有价值信息。总体而言,哮喘患者与非哮喘患者的临床结局并无显著差异,尽管哮喘患者有更多的呼吸系统并发症。有必要进行进一步研究,以更深入地探究过敏反应的多因素性质及其在临床实践中的影响。