Introduction
Materials and methods
Study participants
Study design
Statistical analyses
Results
Patients and anaphylaxis elicitors
All no. (%) (n = 91) | 0–5 years no. (%) (n = 32) | 6–12 years no. (%) (n = 24) | 13–17 years no. (%) (n = 35) |
χ
2
|
P * | |
---|---|---|---|---|---|---|
Demographics | ||||||
Male | 56(62) | 20(63) | 11(46) | 25(71) | 3.960 | 0.138 |
Female | 35(39) | 12(38) | 13(54) | 10(29) | ||
Admission diagnoses | ||||||
Infectious | 49(54) | 20(63) | 12(50) | 17(49) | 1.499 | 0.473 |
RTI | 38(42) | 18(56) | 8(33) | 12(34) | 4.267 | 0.118 |
Stress/operation/trauma | 15(17) | 3(9) | 2(8) | 10(29) | 0.061 | |
Tumor | 10(11) | 4(13) | 3(13) | 3(9) | 0.837 | |
Gastrointestinal disease | 8(9) | 3(9) | 2(8) | 3(9) | 1.000 | |
Rheumatological disease | 4(4) | 2(6) | 2(8) | 0(0) | 0.184 | |
Asthma | 1(1) | 0(0) | 1(4) | 0(0) | 0.264 | |
Cardiovascular disease | 2(2) | 0(0) | 0(0) | 2(6) | 0.334 | |
Other diseases† | 0(0) | 0(0) | 0(0) | 0(0) | – | |
Elicitors | ||||||
Antibiotics | 48(53) | 17(53) | 14(58) | 17(49) | 0.547 | 0.761 |
Cephalosporins | 31(34) | 13(41) | 10(42) | 8(23) | 3.188 | 0.203 |
Macrolides | 7(8) | 1(3) | 3(13) | 3(9) | 0.421 | |
Penicillins | 3(3) | 0(0) | 1(4) | 2(6) | 0.479 | |
Other antibiotics‡ | 7(8) | 3(9) | 0(0) | 4(11) | 0.282 | |
TCM injection¶ | 8(9) | 2(6) | 1(4) | 5(14) | 0.453 | |
Biologics | 7(8) | 1(3) | 0(0) | 6(17) | 0.032 | |
Radiocontrast agents | 4(4) | 0(0) | 3(13) | 1(3) | 0.088 | |
Glucocorticoids | 3(3) | 0(0) | 1(4) | 2(6) | 0.479 | |
Chemotherapeutic agents | 3(3) | 1(3) | 1(4) | 1(3) | 1.000 | |
Anesthetics | 3(3) | 3(9) | 0(0) | 0(0) | 0.057 | |
IV mucosolvan | 2(2) | 2(7) | 0(0) | 0(0) | 0.189 | |
Antivirus | 1(1) | 1(3) | 0(0) | 0(0) | 0.615 | |
Vaccine | 0(0) | 0(0) | 0(0) | 0(0) | – | – |
NSAIDs | 0(0) | 0(0) | 0(0) | 0(0) | – | – |
Others§ | 11(12) | 4(13) | 4(17) | 3(9) | 0.606 |
Clinical features
All no. (%) (n = 91) | 0–5 years no. (%) (n = 32) | 6–12 years no. (%) (n = 24) | 13–17 years no. (%) (n = 35) |
χ
2
|
P * | |
---|---|---|---|---|---|---|
Mucocutaneous | 54(59) | 22(69) | 14(58) | 18(51) | 2.092 | 0.351 |
Flushing | 21(23) | 11(34) | 4(17) | 6(17) | 3.551 | 0.169 |
Pruritus | 16(18) | 4(13) | 5(21) | 7(20) | 0.649 | |
Diffuse urticaria | 33(36) | 13(41) | 8(33) | 12(34) | 0.412 | 0.814 |
Angioedema | 10(11) | 4(13) | 3(13) | 3(9) | 0.837 | |
Conjunctivitis | 9(10) | 2(6) | 3(13) | 4(11) | 0.742 | |
Respiratory system | 66(73) | 25(78) | 19(79) | 22(63) | 2.677 | 0.265 |
Rhinorrhea | 1(1) | 0(0) | 1(4) | 0(0) | 0.264 | |
Cough | 3(3) | 0(0) | 0(0) | 3(9) | 0.111 | |
Voice change | 3(3) | 0(0) | 1(4) | 2(6) | 0.479 | |
Dyspnea | 22(24) | 7(22) | 7(29) | 8(23) | 0.517 | 0.822 |
Wheezing | 21(23) | 7(22) | 7(29) | 7(20) | 0.772 | 0.704 |
Cyanosis | 36(40) | 18(56) | 11(46) | 7(20) | 9.724 | 0.008 |
Respiratory arrest | 2(2) | 1(3) | 0(0) | 1(3) | 1.000 | |
Hypoxemia | 8(9) | 2(6) | 4(17) | 2(6) | 0.368 | |
Cardiovascular system | 71(78) | 23(72) | 15(63) | 33(94) | 9.476 | 0.009 |
Hypotension | 69(76) | 22(69) | 14(58) | 33(94) | 11.386 | 0.003 |
Cardiac arrest | 1(1) | 0(0) | 0(0) | 1(3) | 1.000 | |
Incontinence | 3(3) | 0(0) | 1(4) | 2(6) | 0.479 | |
Gastrointestinal system | 33(36) | 10(31) | 10(42) | 13(37) | 0.663 | 0.718 |
Emesis | 27(30) | 8(25) | 9(38) | 10(29) | 1.060 | 0.589 |
Nausea | 12(13) | 0(0) | 5(21) | 7(20) | 0.010 | |
Abdominal cramping | 13(14) | 5(16) | 5(21) | 3(9) | 0.382 | |
Diarrhea | 0(0) | 0(0) | 0(0) | 0(0) | – | – |
Neurological system | 35(39) | 8(25) | 8(33) | 19(54) | 6.420 | 0.040 |
Presyncope | 22(24) | 6(19) | 6(25) | 10(29) | 0.892 | 0.640 |
Syncope | 17(19) | 6(19) | 2(8) | 9(26) | 0.254 | |
Convulsion | 4(4) | 1(3) | 0(0) | 3(9) | 0.447 | |
Severity of anaphylaxis | ||||||
Mild to moderate | 15(17) | 10(31) | 4(17) | 1(3) | 0.005 | |
Severe | 76(84) | 22(69) | 20(83) | 34(97) | ||
Outcome | ||||||
Death | 1(1) | 0(0) | 0(0) | 1(3) | 1.000 | |
ICU admission | 7(8) | 4(13) | 2(8) | 1(3) | 0.325 |
Analysis of therapies for the treatment of anaphylaxis
Analysis of initial administration routes and initial dosing of epinephrine
Severity of anaphylaxis | IM injection, no. (%) (n = 11) | SC injection, no. (%) (n = 14) | IV bolus, no. (%) (n = 12) | ||||||
---|---|---|---|---|---|---|---|---|---|
Supratherapeutic dosing | Recommended dosing |
P
| Supratherapeutic dosing | Recommended dosing |
P
| Supratherapeutic dosing | Recommended dosing |
P
| |
Mild to moderate | 1(25) | 2(29) | 1.000 | 2(40) | 1(11) | 0.505 | 0(0) | 1(100) | 0.083 |
Severe | 3(75) | 5(71) | 3(60) | 8(89) | 11(100) | 0(0) |
Number | Age (years) | Epinephrine as an initial treatment* | Route of epinephrine | Dose of epinephrine (mg) |
---|---|---|---|---|
1 | 2.5 | Y | IV bolus | 0.50 |
2 | 4.0 | Y | IV bolus | 0.50 |
3 | 4.2 | Y | IV bolus | 3.00 |
4 | 9.0 | N | IV bolus | 0.50 |
5 | 10.0 | N | IV bolus | 0.30 |
6 | 10.2 | Y | IV bolus | 1.00 |
7 | 13.0 | Y | IV bolus | 0.50 |
8 | 14.2 | N | IV bolus | 0.50 |
9 | 14.9 | N | IV bolus | 0.50 |
10 | 15.1 | N | IV bolus | 1.00 |
11 | 17.9 | Y | IV bolus | 0.20 |
12 | 4.0 | Y | IM | 0.20 |
13 | 4.7 | Y | IM | 0.33 |
14 | 8.5 | N | IM | 1.00 |
15 | 17.2 | Y | IM | 1.00 |
16 | 2.0 | Y | SC | 0.30 |
17 | 3.7 | Y | SC | 0.50 |
18 | 3.8 | Y | SC | 0.30 |
19 | 4.0 | Y | SC | 0.30 |
20 | 5.8 | Y | SC | 0.40 |