Clinical Profile of Patients With Severe Anaphylaxis Hospitalized in the Spanish Hospital System: 1997-2011.
OBJECTIVE
Studies assessing the severity of anaphylaxis lack a comprehensive approach to collecting data on comorbidities that may worsen prognosis. Objective: Using the Elixhauser score (a systematic index associated with longer stay, hospital charges, and mortality), we determined which comorbidities were associated with more severe anaphylaxis.


METHODS
We based our study on the Spanish Ministry of Health database of hospital discharges in Spain between 1997 and 2011. We constructed logistic regression models in which the dependent variables were outcomes related to greater severity (death, cardiac arrest, need for invasive mechanical ventilation or vasopressor drugs, admission to the intensive care unit, and length of stay) and the independent variables were the 30 comorbidities that comprise the Elixhauser score, age, sex, and main causes of anaphylaxis.


RESULTS
We found that a higher risk of severe anaphylaxis was associated (3 or more logistic regressions) with age >50 years or having experienced cardiac arrhythmia, coagulation disorder, associated fluid-electrolyte imbalance, chronic pulmonary disease, or Echinococcus anaphylaxis. Likewise, in the adjusted analysis, a higher Elixhauser score was associated with most of the outcomes analyzed for severity of anaphylaxis.


CONCLUSIONS
Cardiovascular and respiratory diseases increase the severity of anaphylaxis, and the resulting poor health status (represented as a higher Elixhauser score) is associated with more severe anaphylaxis.
Allergy Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.|International Doctoral School, Universidad Rey Juan Carlos, Alcorcón, Spain.
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Nieto-Nieto
Allergy Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.|Medicine Department, Universidad Rey Juan Carlos, Alcorcón, Spain.
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Tejedor-Alonso
Allergy Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.|International Doctoral School, Universidad Rey Juan Carlos, Alcorcón, Spain.
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Farias-Aquino
Allergy Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
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Moro-Moro
Allergy Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
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Rosado Ingelmo
Allergy Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
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Gonzalez-Moreno
Preventive Medicine and Public Health Area, Universidad Rey Juan Carlos, Alcorcón, Spain.
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Gil de Miguel
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000707:Anaphylaxis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006304:Health Status; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
Anaphylaxis; Cardiovascular; Comorbidities; Diseases; Elixhauser score; Respiratory; Severity