Are Children with a History of Asthma More Likely to Have Severe Anaphylactic Reactions? A Retrospective Cohort Study
To assess whether a history of asthma was associated with anaphylaxis severity in children hospitalized for anaphylaxis. Retrospective cohort study of children ≤21 years old hospitalized for anaphylaxis from 2009 to 2016. The primary outcome was severe anaphylactic reactions defined by examination f...
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Veröffentlicht in: | The Journal of pediatrics 2020-05, Vol.220, p.159-164.e2 |
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creator | Dribin, Timothy E. Michelson, Kenneth A. Zhang, Yin Schnadower, David Neuman, Mark I. |
description | To assess whether a history of asthma was associated with anaphylaxis severity in children hospitalized for anaphylaxis.
Retrospective cohort study of children ≤21 years old hospitalized for anaphylaxis from 2009 to 2016. The primary outcome was severe anaphylactic reactions defined by examination findings (stridor, respiratory distress, or hypotension) or administered therapies (≥2 dose of intramuscular epinephrine, continuous albuterol, vasopressors, or positive pressure ventilation). Multivariable analyses were used to assess whether a history of asthma was associated with severe anaphylactic reactions, adjusting for patient age, allergen, and history of atopic dermatitis or anaphylaxis.
Among 603 children hospitalized for anaphylaxis, 231 (38.3%) had a history of asthma. Children with a history of asthma were older (median age, 6.6 years [IQR, 3.6-12.1] vs 4.0 years [IQR, 1.6-9.3]), more likely to have a history of anaphylaxis (38.1% vs 18.0%), and have food as the inciting allergen (68.0% vs 52.2%). Children with a history of asthma were not more likely to have severe anaphylactic reactions (OR, 0.97; 95% CI, 0.67-1.39).
Children hospitalized for anaphylaxis with a history of asthma were not more likely to have severe anaphylactic reactions compared with children without asthma. This study supports managing children with anaphylaxis based on the severity of symptomatology, and, if validated, clinicians should not consider asthma comorbidity as a stand-alone criterion for hospitalization. |
doi_str_mv | 10.1016/j.jpeds.2019.12.019 |
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Retrospective cohort study of children ≤21 years old hospitalized for anaphylaxis from 2009 to 2016. The primary outcome was severe anaphylactic reactions defined by examination findings (stridor, respiratory distress, or hypotension) or administered therapies (≥2 dose of intramuscular epinephrine, continuous albuterol, vasopressors, or positive pressure ventilation). Multivariable analyses were used to assess whether a history of asthma was associated with severe anaphylactic reactions, adjusting for patient age, allergen, and history of atopic dermatitis or anaphylaxis.
Among 603 children hospitalized for anaphylaxis, 231 (38.3%) had a history of asthma. Children with a history of asthma were older (median age, 6.6 years [IQR, 3.6-12.1] vs 4.0 years [IQR, 1.6-9.3]), more likely to have a history of anaphylaxis (38.1% vs 18.0%), and have food as the inciting allergen (68.0% vs 52.2%). Children with a history of asthma were not more likely to have severe anaphylactic reactions (OR, 0.97; 95% CI, 0.67-1.39).
Children hospitalized for anaphylaxis with a history of asthma were not more likely to have severe anaphylactic reactions compared with children without asthma. This study supports managing children with anaphylaxis based on the severity of symptomatology, and, if validated, clinicians should not consider asthma comorbidity as a stand-alone criterion for hospitalization.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2019.12.019</identifier><identifier>PMID: 31987654</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>biphasic anaphylaxis ; emergency department</subject><ispartof>The Journal of pediatrics, 2020-05, Vol.220, p.159-164.e2</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-cc4576b89bb6b5215565221b18205e5dfa8455c985c425b2d9ab0a0015e012133</citedby><cites>FETCH-LOGICAL-c404t-cc4576b89bb6b5215565221b18205e5dfa8455c985c425b2d9ab0a0015e012133</cites><orcidid>0000-0002-6127-7535</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2019.12.019$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31987654$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dribin, Timothy E.</creatorcontrib><creatorcontrib>Michelson, Kenneth A.</creatorcontrib><creatorcontrib>Zhang, Yin</creatorcontrib><creatorcontrib>Schnadower, David</creatorcontrib><creatorcontrib>Neuman, Mark I.</creatorcontrib><title>Are Children with a History of Asthma More Likely to Have Severe Anaphylactic Reactions? A Retrospective Cohort Study</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To assess whether a history of asthma was associated with anaphylaxis severity in children hospitalized for anaphylaxis.
Retrospective cohort study of children ≤21 years old hospitalized for anaphylaxis from 2009 to 2016. The primary outcome was severe anaphylactic reactions defined by examination findings (stridor, respiratory distress, or hypotension) or administered therapies (≥2 dose of intramuscular epinephrine, continuous albuterol, vasopressors, or positive pressure ventilation). Multivariable analyses were used to assess whether a history of asthma was associated with severe anaphylactic reactions, adjusting for patient age, allergen, and history of atopic dermatitis or anaphylaxis.
Among 603 children hospitalized for anaphylaxis, 231 (38.3%) had a history of asthma. Children with a history of asthma were older (median age, 6.6 years [IQR, 3.6-12.1] vs 4.0 years [IQR, 1.6-9.3]), more likely to have a history of anaphylaxis (38.1% vs 18.0%), and have food as the inciting allergen (68.0% vs 52.2%). Children with a history of asthma were not more likely to have severe anaphylactic reactions (OR, 0.97; 95% CI, 0.67-1.39).
Children hospitalized for anaphylaxis with a history of asthma were not more likely to have severe anaphylactic reactions compared with children without asthma. This study supports managing children with anaphylaxis based on the severity of symptomatology, and, if validated, clinicians should not consider asthma comorbidity as a stand-alone criterion for hospitalization.</description><subject>biphasic anaphylaxis</subject><subject>emergency department</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kMFq3DAQhkVoaDZpnyBQdOzFzki2vPYhFLO03cCGQJKehSzPYm29livJW_z20WaTHnv6meGbGekj5JpByoAVN7t0N2LrUw6sShlPY5yRBYNqmRRlln0gCwDOkyxfFhfk0vsdAFQ5wEdykbGqXBYiX5CpdkhXnelbhwP9a0JHFV0bH6ybqd3S2odur-i9jdjG_MZ-psHStTogfcIDxm49qLGbe6WD0fQRj2kH_43WsQjO-hFjJ-Ir21kX6FOY2vkTOd-q3uPnt7wiv358f16tk83Dz7tVvUl0DnlItM7FsmjKqmmKRnAmRCE4Zw0rOQgU7VaVuRC6KoXOuWh4W6kGFAATCIyzLLsiX097R2f_TOiD3Buvse_VgHbykkc5AoqyrCKanVAd3-wdbuXozF65WTKQR99yJ199y6NvybiMEae-vB2Ymj22_2beBUfg9gRg_ObBoJNeGxw0tsZFMbK15r8HXgBH1ZGU</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Dribin, Timothy E.</creator><creator>Michelson, Kenneth A.</creator><creator>Zhang, Yin</creator><creator>Schnadower, David</creator><creator>Neuman, Mark I.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6127-7535</orcidid></search><sort><creationdate>202005</creationdate><title>Are Children with a History of Asthma More Likely to Have Severe Anaphylactic Reactions? A Retrospective Cohort Study</title><author>Dribin, Timothy E. ; Michelson, Kenneth A. ; Zhang, Yin ; Schnadower, David ; Neuman, Mark I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-cc4576b89bb6b5215565221b18205e5dfa8455c985c425b2d9ab0a0015e012133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>biphasic anaphylaxis</topic><topic>emergency department</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dribin, Timothy E.</creatorcontrib><creatorcontrib>Michelson, Kenneth A.</creatorcontrib><creatorcontrib>Zhang, Yin</creatorcontrib><creatorcontrib>Schnadower, David</creatorcontrib><creatorcontrib>Neuman, Mark I.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dribin, Timothy E.</au><au>Michelson, Kenneth A.</au><au>Zhang, Yin</au><au>Schnadower, David</au><au>Neuman, Mark I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are Children with a History of Asthma More Likely to Have Severe Anaphylactic Reactions? A Retrospective Cohort Study</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2020-05</date><risdate>2020</risdate><volume>220</volume><spage>159</spage><epage>164.e2</epage><pages>159-164.e2</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To assess whether a history of asthma was associated with anaphylaxis severity in children hospitalized for anaphylaxis.
Retrospective cohort study of children ≤21 years old hospitalized for anaphylaxis from 2009 to 2016. The primary outcome was severe anaphylactic reactions defined by examination findings (stridor, respiratory distress, or hypotension) or administered therapies (≥2 dose of intramuscular epinephrine, continuous albuterol, vasopressors, or positive pressure ventilation). Multivariable analyses were used to assess whether a history of asthma was associated with severe anaphylactic reactions, adjusting for patient age, allergen, and history of atopic dermatitis or anaphylaxis.
Among 603 children hospitalized for anaphylaxis, 231 (38.3%) had a history of asthma. Children with a history of asthma were older (median age, 6.6 years [IQR, 3.6-12.1] vs 4.0 years [IQR, 1.6-9.3]), more likely to have a history of anaphylaxis (38.1% vs 18.0%), and have food as the inciting allergen (68.0% vs 52.2%). Children with a history of asthma were not more likely to have severe anaphylactic reactions (OR, 0.97; 95% CI, 0.67-1.39).
Children hospitalized for anaphylaxis with a history of asthma were not more likely to have severe anaphylactic reactions compared with children without asthma. This study supports managing children with anaphylaxis based on the severity of symptomatology, and, if validated, clinicians should not consider asthma comorbidity as a stand-alone criterion for hospitalization.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31987654</pmid><doi>10.1016/j.jpeds.2019.12.019</doi><orcidid>https://orcid.org/0000-0002-6127-7535</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | biphasic anaphylaxis emergency department |
title | Are Children with a History of Asthma More Likely to Have Severe Anaphylactic Reactions? A Retrospective Cohort Study |
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