Predictors of severe and recurrent adult anaphylaxis, and gaps in the cascade of care: a retrospective, single‐centre study 2009–2018

Background Anaphylaxis is a severe, potentially fatal, systemic allergic reaction. Understanding predictors of recurrent and severe anaphylaxis in adults, and identifying gaps in ongoing anaphylaxis care, is needed to minimise its impact. Aims To evaluate the risk factors in adults with severe and recurrent anaphylaxis presentations and to evaluate the management of patients in regard to the recommended cascade of care. Methods We completed a retrospective audit of adults with confirmed anaphylaxis who presented to an inner‐city emergency department from 1 January 2009 through 31 December 2018. Data recorded included demographics, background history, medication use, severity, co‐factors, triggers, management, discharge disposition and referral for follow‐up. Data were managed in REDCap and analysed using Stata. Associations were assessed through odds ratios (ORs) and t tests. Results Six hundred sixteen individuals had 689 episodes of anaphylaxis over the audit period. Age over 65 (OR: 5.4 (95% confidence interval, CI: 2.3–13.2), P