title: Predictors of the severity and serious outcomes of anaphylaxis in korean adults: a multicenter retrospective case study.
abstract: OBJECTIVE
  Differences in definitions of the condition, relevant triggers, and the geographical locations of study centers, cause estimates of the prevalence of anaphylaxis to vary. Recent epidemiological data indicate that the incidence of anaphylaxis is rising.
  
  
  METHODS
  To investigate the causes and clinical features of anaphylaxis in Korean adults, factors associated with the severity of the condition, and serious outcomes, a retrospective medical record review was performed on adult patients diagnosed with anaphylaxis between 2007 and 2011 in 15 University Hospitals of South Korea.
  
  
  RESULTS
  A total of 1,806 cases (52% male, age 16-86 years) were reported. Cutaneous symptoms (84.0%), combined with respiratory (53.9%) and/or cardiovascular (55.4%) symptoms, were the most frequent presentations. Using a recognized grading system, 1,776 cases could be classified as either mild, 340; moderate, 690; or severe, 746. Although eliciting factors varied significantly by age, gender, and regional and seasonal factors, drugs (46.5%; including nonsteroidal anti-inflammatory drugs, antibiotics, and radiocontrast media) were the most common cause of anaphylaxis, followed by foods (24.2%), insect stings (16.4%), exercise (5.9%), and unknown etiology (7.0%). All of age, multi-organ involvement, a history of allergic disease, and drug-induced anaphylaxis, were significant predictors of serious outcomes requiring hospital admission or prolongation of hospital stay. Epinephrine auto-injectors were prescribed for 7.4% of reported cases.
  
  
  CONCLUSIONS
  The principal causes of anaphylaxis in Korean adults were drugs, food, and insect stings. Drug-associated anaphylaxis, a history of allergic disease, multi-organ involvement, and older age, were identified as predictors of serious outcomes.
authors.affiliation: Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Ye
authors.affiliation: Department of Allergy and Clinical Immunology, Chungbuk National University, Cheongju, Korea.
authors.forename: Mi Kyeong
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hye-Ryun
authors.initials: HR
authors.lastname: Kang
authors.affiliation: Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Tae-Bum
authors.initials: TB
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Sohn
authors.affiliation: Department of Allergy and Clinical Immunology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Young-Il
authors.initials: YI
authors.lastname: Koh
authors.affiliation: Department of Allergy and Clinical Immunology, Pusan National University Hospital, Busan, Korea.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Park
authors.affiliation: Department of Allergy and Clinical Immunology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Gwang Cheon
authors.initials: GC
authors.lastname: Jang
authors.affiliation: Department of Allergy and Clinical Immunology, Inha University College of Medicine, Incheon, Korea.
authors.forename: Cheol-Woo
authors.initials: CW
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Young-Koo
authors.identifier: 0000-0001-5800-8038
authors.initials: YK
authors.lastname: Jee
authors.affiliation: Department of Allergy and Clinical Immunology, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Gyu-Young
authors.initials: GY
authors.lastname: Hur
authors.affiliation: Department of Allergy and Clinical Immunology, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Joo-Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Kosin University College of Medicine, Busan, Korea.
authors.forename: Gil-Soon
authors.initials: GS
authors.lastname: Choi
authors.affiliation: Department of Allergy and Clinical Immunology, Dong-A University, College of Medicine, Busan, Korea.
authors.forename: Soo-Keol
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Hae-Sim
authors.identifier: 0000-0003-2614-0303
authors.initials: HS
authors.lastname: Park
keywords: Anaphylaxis; adult; epidemiology; multicenter study; serious outcomes; severity