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2003年至2023年中国武汉住院患者过敏反应的发病率及趋势:一项多中心回顾性研究

Incidence and trends of anaphylaxis among inpatients from 2003 to 2023 in Wuhan, China: A multicenter retrospective study.

作者信息

Li Le, Huang Nan, Li Wenjing, Yang Yaqi, Ma Dongxia, Chen Hao, Zhu Rongfei

机构信息

Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

World Allergy Organ J. 2024 Oct 30;17(11):100980. doi: 10.1016/j.waojou.2024.100980. eCollection 2024 Nov.

Abstract

BACKGROUND

The incidence of a disease can help health professionals to identify risk factors and health-care policymakers to develop corresponding policies. The realization of both purposes depends on comprehensive studies, especially studies done on a large scale. However, comprehensive studies on the incidence of anaphylaxis among inpatients in China are still notably scarce. Hence we aim to explore the incidence and clinical characteristics of anaphylaxis among inpatients over a span of 21 years in Wuhan, China.

METHODS

We retrieved data on anaphylaxis cases from the Data Platform Application Portal (DPAP) across 3 medical centers of Tongji Hospital, Wuhan, China from January 1, 2003, to December 31, 2023.

RESULTS

The data encompassed a total of 362 anaphylaxis patients from 2,139,272 inpatients. Among them 204 (56.4%) were male, and the median age was 45 years old. Over the past 2 decades, the incidence rate of anaphylaxis at Tongji Hospital was 16.92 per 100,000 individuals. After adjusting for gender and age, the annual standardized incidence rate was 234.53 per 100,000 individuals. The incidence rate of anaphylaxis among the inpatients revealed a relatively stable but slowly rising trend over the 21-year observation period. As for the triggers of anaphylaxis, drugs were responsible for 73.6% of triggers, with antibiotics representing the highest proportion of these cases (38.4%). Drug triggers also showed age-specific features: chemotherapy (17.9%) had the highest proportions among children aged 0-3 years; blood products were more prevalent in school-age children. 13.5% of the cases had an unknown cause. In anaphylaxis cases, despite that only 36.0% received epinephrine treatment, the application of epinephrine still showed an ascending trend. Moreover, the mortality rate for anaphylaxis was relatively low (1.6%), displaying a consistent downward trend.

CONCLUSION

Our study provides insights into the incidence of anaphylaxis among inpatients in Wuhan over a 21-year period. Drugs are the most common triggers for anaphylaxis, and the use of epinephrine in anaphylaxis management is far from optimal.

摘要

背景

一种疾病的发病率有助于卫生专业人员识别风险因素,并有助于卫生保健政策制定者制定相应政策。实现这两个目标都依赖于全面的研究,尤其是大规模研究。然而,关于中国住院患者过敏反应发病率的全面研究仍然非常匮乏。因此,我们旨在探讨中国武汉21年间住院患者过敏反应的发病率及临床特征。

方法

我们从中国武汉同济医院3个医疗中心的数据平台应用门户(DPAP)中检索了2003年1月1日至2023年12月31日期间过敏反应病例的数据。

结果

数据涵盖了2139272名住院患者中的362例过敏反应患者。其中男性204例(56.4%),中位年龄为45岁。在过去20年中,同济医院过敏反应的发病率为每10万人中16.92例。在调整性别和年龄后,年度标准化发病率为每10万人中234.53例。在21年的观察期内,住院患者中过敏反应的发病率呈现出相对稳定但缓慢上升的趋势。至于过敏反应的诱因,药物引发的占73.6%,其中抗生素所占比例最高(38.4%)。药物引发还呈现出年龄特异性特征:化疗(17.9%)在0至3岁儿童中所占比例最高;血液制品在学龄儿童中更为普遍。13.5%的病例病因不明。在过敏反应病例中,尽管只有36.0%接受了肾上腺素治疗,但肾上腺素的应用仍呈上升趋势。此外,过敏反应的死亡率相对较低(1.6%),呈持续下降趋势。

结论

我们的研究提供了关于武汉21年间住院患者过敏反应发病率的见解。药物是过敏反应最常见的诱因,肾上腺素在过敏反应治疗中的使用远未达到最佳状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab33/11555331/4692a6850dcf/gr1.jpg

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