A retrospective registry-based study into the proportion of patients admitted to intensive care who have anaphylaxis as a principal diagnosis and their outcomes in Australia and New Zealand.

Autor:	Lim Zee ZJ; Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia.; Department of Anaesthesia and Pain Medicine, Northern Health, Epping, Victoria, Australia., Karalapillai D; Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia.; Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia.; Department of Critical Care, University of Melbourne, Parkville, Victoria, Australia., Kolawole H; Department of Anaesthesia, Peninsula Health, Frankston, Victoria, Australia.; Department of Anaesthesia Teaching and Research, Monash University, Melbourne, Victoria, Australia., Fiddes C; Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia., Pilcher D; Department of Intensive Care, Alfred Hospital, Melbourne, Victoria, Australia.; Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Victoria, Australia.; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Subramaniam A; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Intensive Care, Peninsula Health, Frankston, Victoria, Australia.; Department of Intensive Care, Dandenong Hospital, Monash Health, Dandenong, Victoria, Australia.; Peninsula Clinical School, Monash University, Frankston, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine [Crit Care Resusc] 2024 Aug 03; Vol. 26 (3), pp. 185-191. Date of Electronic Publication: 2024 Aug 03 (Print Publication: 2024).
DOI:	10.1016/j.ccrj.2024.06.002
Abstrakt:	Objective: To describe the proportion of patients admitted to intensive care who have anaphylaxis as a principal diagnosis and their subsequent outcomes in Australia and New Zealand. Design: Retrospective observational study of ICU admissions for severe anaphylaxis. Setting: ICU admissions recorded in the Australian and New Zealand Intensive Care Society Adult Patient Database between 2012 and 2022. Participants: Adults 16 years or older with severe anaphylaxis admitted to the ICU. Interventions: None. Main Outcome Measures: Proportion of patients admitted to ICU who have anaphylaxis as a principal diagnosis, mortality rate, ICU and hospital length of stay. Results: 7189 of the 7270 ICU admissions for severe anaphylaxis recorded between 2012 and 2022, were included in the analysis. This represented a proportion from 0.25% in 2012 to 0.43% in 2022. ICU and hospital mortality were 0.4% and 0.8%, respectively. The proportion of ICUs reporting at least one severe anaphylaxis each year increased from 61.7% in 2012 to 83.0% in 2022. Most of the patients were discharged home (92.6%, n = 6660). Increasing age (OR = 1.055; 95%CI: 1.008-1.105) and SOFA scores (OR = 1.616; 95%CI: 1.265-2.065), an immunosuppressive chronic condition (OR = 16.572; 95%CI: 3.006-91.349) and an increasing respiratory rate above 16 breaths/min (OR = 1.116; 95%CI: 1.057-1.178) predicted in-hospital mortality in patients with anaphylaxis, while higher GCS decreased in-hospital mortality (OR = 0.827; 95%CI: 0.705-0.969). Conclusions: The overall proportion of patients admitted to ICU who have anaphylaxis as a principal diagnosis has increased. In-hospital mortality remains low despite the need for vital organ support. Further studies should investigate these identified factors that may predict in-hospital mortality among these patients. Trial Registration: Not applicable. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ashwin Subramaniam and David Pilcher are associate editors for critical care and resuscitation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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