title: Factors Associated with Echinococcosis-Induced Perioperative Anaphylactic Shock.
abstract: This retrospective case-control study explored the factors associated with anaphylactic shock during surgery for cystic echinococcosis (CE) at the First Affiliated Hospital of Xinjiang Medical University between October 2008 and September 2013. Patients who suffered from anaphylactic shock (n=16) were age-matched 3:1 to patients who did not (n=43). Multivariate analysis suggested that IL-4 levels (odds ratio=1.096; 95% confidence interval=1.015-1.185;P=0.02) and cyst size (odds ratio=3.028, 95% confidence interval=1.259-7.283,P=0.013) were independently associated with CE-induced perioperative anaphylactic shock. Using the receiver operating characteristic (ROC) curves and a cut-off value of 415.7 ng/ml, IL-4 showed an area under the ROC (AUC) of 0.926, sensitivity of 75.0%, and specificity of 97.7%. Using a cut-off value of 7.8 cm, cyst size showed an AUC of 0.828, sensitivity of 81.3%, and specificity of 76.7%. In conclusion, results suggest that levels of IL-4 and cyst size were independently associated with echinococcosis-induced perioperative anaphylactic shock. These results could help identifying patients with echinococcosis at risk of anaphylactic shock in whom appropriate prophylaxis could be undertaken.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Ye
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xuan
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China.
authors.forename: Siyu
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China.
authors.forename: Long
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D004443:Echinococcosis / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015847:Interleukin-4 / Q000097:blood; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult
chemical_list: C508598:IL4 protein, human; D015847:Interleukin-4
keywords: Echinococcus granulosus; anaphylaxis; cystic echinococcosis; hydatid cyst; surgery; zoonotic infectious disease