Background

The estimated worldwide incidence of perioperative or periprocedural anaphylaxis (PA) is between 1 in 1250 and 1 in 20,000 procedures.

Objective

To evaluate the incidence of PA in the United States and compare patient characteristics and underlying risk factors using a large national database.

Methods

Using deidentified data from the nationwide inpatient sample from 2005 to 2014, we identified cases of PA through the International Classification of Diseases, Ninth Revision, Clinical Modification codes and conducted a retrospective analysis.

Results

Among 35,647,347 surgeries and procedures, there were 5458 (0.015%) PA cases identified. The incidence of PA was 15.3 cases per 100,000 procedures. When compared with controls, PA cases had an increased mortality (3.4% vs 1.4%; P < .001), median length of stay (5 vs 3 days; P < .001), and median hospital cost ($45,155 vs $24,734; P < .001). The age group between 18 and 34 years (odds ratio [OR], 1.34; 95% confidence interval [CI], 1.13-1.58; P < .001) and female sex (OR, 1.40; 95% CI, 1.31-1.49; P < .001) were associated with increased odds of PA. Transplant (OR, 3.35; 95% CI, 2.59-4.34; P < .001), hematologic (OR, 1.63; 95% CI, 1.30-2.05; P < .001), vascular (OR, 1.49; 95% CI, 1.30-1.67; P < .001), and cardiac (OR, 1.47; 95% CI, 1.30-1.67; P < .001) procedures were at increased risk for PA. Several comorbidities were associated with PA including chronic pulmonary disease (OR, 1.41; 95% CI, 1.31-1.51; P < .001).

Conclusion

The incidence of PA is 1 in 6531 procedures, with a mortality of 1 in 191,652 procedures. PA has worsening outcomes compared with controls. The risk factors of PA include age, sex, procedure type, and comorbidities.

中文翻译：

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2005年至2014年美国围手术期或术中过敏反应的发生率和危险因素

背景

围手术期或围手术期过敏反应（PA）的全球估计发病率在1250例中的1例与20,000例中的1例之间。

目的

为了评估美国PA的发生率，并使用大型国家数据库来比较患者特征和潜在的危险因素。

方法

我们使用2005年至2014年全国住院患者样本中的不确定数据，通过《国际疾病分类》，《第九修订版》，《临床修改规范》确定了PA病例，并进行了回顾性分析。

结果

在35,647,347例手术和程序中，发现了5458例（0.015％）PA患者。每10万例手术中，PA的发生率为15.3例。当与对照组相比，PA例有增加的死亡率（3.4％对1.4％; P <.001），住院中值长度（5比3天; P <0.001），和中值住院费用（$四五一五五VS $二万四千七百三十四; P <.001）。18至34岁之间的年龄段（比值比[OR]为1.34； 95％置信区间[CI]为1.13-1.58；P <.001）和女性性别（OR为1.40； 95％CI为1.31-1.49；P <.001）与PA几率增加相关。移植（OR，3.35; 95％CI，2.59-4.34; P <.001），血液学（OR，1.63; 95％CI，1.30-2.05; P<.001），血管（OR，1.49; 95％CI，1.30-1.67; P <.001）和心脏（OR，1.47; 95％CI，1.30-1.67; P <.001）手术的风险增加用于PA。几种合并症与PA相关，包括慢性肺部疾病（OR，1.41； 95％CI，1.31-1.51；P <.001）。

结论

在6531例手术中，PA的发生率为1，而在191,652例手术中，死亡率为1。与对照组相比，PA的结局恶化。PA的危险因素包括年龄，性别，手术类型和合并症。