title: Climate data, localisation of the sting, grade of anaphylaxis and therapy of hymenoptera stings.
abstract: International epidemiological studies indicate that around 1-7% of the population respond with an allergic reaction to a hymenoptera sting, which is frequently associated with admission to an emergency department. This retrospective study included patients admitted between 2009 and 2013 to an emergency department after a hymenoptera sting. In all, 86 (60.1%) men and 57 (39.9%) women were included in the study. The mean age was 43 years, with a range from 19 to 84 years. The most common localisations of a sting were the head (n = 33; 22.5%), the hands (n = 32; 21.9%) and the arms (n = 26; 17.8%). In women, we recorded significantly more stings in distal extremities (p = 0.033) and in men stings in the rump and head were most frequent. Local swellings were observed in 67.1% (n = 96) of patients and 34.3% (n = 49) patients exhibited an anaphylactic reaction. Of these, 21.7% (n = 31) suffered from a grade I, 6.3% (n = 9) grade II, 4.2% (n = 6) grade III and 2.1% (n = 3) grade IV anaphylactic reactions. 46% (66) of the patients were given antihistamines, 45% (64) intravenous glucocorticoids and only 12.5% (16) epinephrine. Most stings were recorded on days without rainfall (p = 0.013), with more hours of sunshine (p = 0.001), low relative humidity (p = 0.006), with mean air pressure above 954.3 hPa and on days with mean temperature above 24.2 °C (p = 0.001). In conclusion, the most hymenoptera stings induced local swelling only; severe reactions were rare. The most dangerous stings are enoral and result from inattentive drinking. Epinephrine was rarely used in anaphylactic reactions.
authors: University Emergency Department, Insel Hospital, University Hospital Bern, Switzerland.
authors: Christian Tasso
authors: CT
authors: Braun
authors: University Emergency Department, Insel Hospital, University Hospital Bern, Switzerland.
authors: Mirko
authors: M
authors: Mikula
authors: University Emergency Department, Insel Hospital, University Hospital Bern, Switzerland.
authors: Meret Elisabeth
authors: ME
authors: Ricklin
authors: University Emergency Department, Insel Hospital, University Hospital Bern, Switzerland.
authors: Aristomenis K
authors: AK
authors: Exadaktylos
authors: University Clinic for Rheumatology, Immunology and Allergology, Insel Hospital, University Hospital Bern, Switzerland.
authors: Arthur
authors: A
authors: Helbling
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000399:Air Pressure; D000707:Anaphylaxis / Q000188:drug therapy* / Q000453:epidemiology; D000818:Animals; D001132:Arm; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006257:Head; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006785:Hospitals, University; D006801:Humans; D006813:Humidity; D006927:Hymenoptera; D007299:Insect Bites and Stings / Q000188:drug therapy* / Q000453:epidemiology; D007866:Leg; D008297:Male; D008875:Middle Aged; D011891:Rain; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013472:Sunlight; D013557:Switzerland / Q000453:epidemiology; D013566:Sympathomimetics / Q000627:therapeutic use*; D014887:Weather; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D006633:Histamine Antagonists; D013566:Sympathomimetics; D004837:Epinephrine