Anaphylaxis—a rapid-onset, multisystem, and potentially fatal hypersensitivity reaction—doesn’t happen often, but it can have severe—or even fatal—effects in children. A new study sought to determine the prevalence, incidence, and mortality of pediatric anaphylaxis. The report in the Journal of Allergy and Clinical Immunology: In Practice focused on pediatric anaphylaxis admissions with a comprehensive analysis of identified triggers, clinical and demographic information, and probability of death.
Mount Sinai School of Medicine–led researchers described the epidemiology of pediatric anaphylaxis based on admissions to North American pediatric intensive care units (PICUs) that were prospectively enrolled in the Virtual Pediatric Systems database from 2010 to 2015.
Touted as the largest of its kind, the study involved 131 PICUs in the United States and Canada, and 1,989 admissions of patients younger than age 18 years met the criteria for participation.
Mortality was defined as the primary outcome, and secondary outcomes included intubation, length of stay, mortality-risk scores, systolic blood pressure, and pupillary reflex.
Researchers said the death rate from critical anaphylaxis was 1.0% and that triggers for fatal cases included peanuts, the most common trigger; milk; and blood products. The study pointed out that patients younger than age 13 years were mostly male and those aged 13 years and older were mostly female. The average length of stay was 2 days.
The study team also identified a higher proportion of Asian patients younger than age 2 years or when the trigger was food.
“This is the largest study to describe pediatric critical anaphylaxis cases in North America and identifies food as the most common trigger,” the study authors concluded. “Death occurs in 1% of cases, with intubation occurring most commonly in the first hour. The risk for intensive care unit admission in children underscores the serious nature of anaphylaxis in this population.”
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