Korean J Dermatol.  2019 Mar;57(3):126-135.

Clinical and Statistical Analysis of Patients with Anaphylaxis Visiting the Emergency Room of a Tertiary Hospital

Affiliations
  • 1Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
  • 2Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
  • 3Division of Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
  • 4Department of Dermatology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. freesia0210@naver.com

Abstract

BACKGROUND
Understanding the epidemiology of anaphylaxis is imperative for appropriate diagnosis and treatment, but the prevalence reportedly varies and only a few studies have compared the clinical features of anaphylaxis with the underlying causes in Korea.
OBJECTIVE
This study aimed to investigate the etiology and clinical features of anaphylaxis.
METHODS
We retrospectively reviewed the medical records of 319 anaphylaxis patients who visited our emergency room and extracted information on the causes, clinical characteristics, and subsequent outpatient visits.
RESULTS
Food, drugs, and environmental factors were common causes of anaphylaxis. Statistically significant differences (p<0.001) were observed between children (<18 years of age) and adults (≥18 years of age), with food and drugs identified as the most common causes, respectively. Clinical characteristics of the patients were compared according to the common causes of anaphylaxis. Cutaneous symptoms were observed more frequently in food-induced cases (n=137, 95.1%) compared to drug-induced (n=73, 77.7%) and bee sting-induced (n=18, 78.3%) cases (p<0.001), whereas neurological symptoms were observed more frequently in drug-induced (n=37, 39.4%) and bee sting-induced (n=11, 47.8%) cases than in food-induced (n=18, 12.5%) cases (p<0.01). Drug-induced (n=44, 46.8%) and bee sting-induced (n=11, 47.8%) cases were more severe than food-induced cases (n=32, 22.2%). Out of the 319 assessed patients, only 25, 14, and 14 patients were referred to the pediatrics, allergy, and dermatology departments, respectively, after visiting the emergency room.
CONCLUSION
Clinical characteristics of anaphylactic patients differed according to the underlying cause, but these findings are presumably influenced by factors determining the severity of anaphylaxis. We found that subsequent follow-up care in other departments to identify the cause of anaphylaxis was inadequate for most patients.

Keyword

Anaphylaxis; Dermatologists; Epidemiology

MeSH Terms

Adult
Anaphylaxis*
Bees
Child
Dermatology
Diagnosis
Emergencies*
Emergency Service, Hospital*
Epidemiology
Follow-Up Studies
Humans
Hypersensitivity
Korea
Medical Records
Outpatients
Pediatrics
Prevalence
Retrospective Studies
Tertiary Care Centers*
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