Anaphylaxis among elderly emergency department patients in a large health system in New York

Meir, Lea R.; Habbsa, Samima; Waqar, Omar; League, Christopher; Li, Timmy; Jongco, Artemio M.

doi:10.1016/j.anai.2022.03.020

Cited by 6 publications

(3 citation statements)

References 57 publications

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“…Whether concomitant medications such as β-blockers or ACEI are able to aggravate anaphylaxis is still being debated [3]. Finally, recent studies confirm that older age and drug-related triggers are all consistently associated with severity of anaphylaxis and death [8 ▪ ,16 ▪ ].…”

Section: Discussionmentioning

confidence: 99%

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Anaphylaxis in elderly people

Ventura

Boni²,

Taborda-Barata

et al. 2022

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewAnaphylaxis is common in old-age adults but is insufficiently understood by physicians, and may be underdiagnosed. This review discusses the specificities of anaphylaxis in this age group and stresses the importance of adrenaline in its management.Recent findingsData from the European Anaphylaxis Registry on elderly patients is a major finding. Other findings include the prevention of possible anaphylactic reactions in coronavirus disease 2019 vaccination as well as some new epidemiologic data.SummaryThe most common risk factors are hymenoptera venom and food and drug allergy. Cardiovascular symptoms are the most important ones to reverse in old-age adults, especially due to the multiple comorbidities. Anaphylaxis in old-age adults has a more severe outcome than in younger ones. Polypharmacy is a specific factor to be considered. The Airway, Breathing, Circulation, Disability, Exposure (ABCDE) algorithm is applicable in all clinical emergencies for immediate assessment and treatment, and should be considered for all patients. Adrenaline is the mainstay of the management of the condition. There are no absolute contraindications to the prescription of self-injectable adrenaline in elderly individuals at risk of anaphylaxis.

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Section: Discussionmentioning

confidence: 99%

“…Analgesics (metamizole, diclofenac, ibuprofen) and antibiotics (penicillin, cephalosporins, quinolones) are the most frequent drugs associated with anaphylaxis in this age group [4 ▪▪ ]. On the other hand, drug-related anaphylaxis appears to be the first cause of Emergency Department visits in the United States [8 ▪ ,16 ▪ ].…”

Section: Eliciting Factorsmentioning

confidence: 99%

Anaphylaxis in elderly people

Ventura

Boni²,

Taborda-Barata

et al. 2022

Current Opinion in Allergy &Amp; Clinical Immunology

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“…Efforts to improve adherence to guidelines have yielded good results for drug hypersensitivity reactions occurring in the perioperative context [9], but less so in other settings, such as patients presenting at the emergency department. As an example, only 1% of elderly patients presenting with anaphylaxis (44% drug-induced) underwent tryptase sampling during an emergency department visit in a major U. S. city [51]. Pediatric data are scarce.…”

Section: Serum Tryptase and Drug Hypersensitivity: What Is Next?mentioning

confidence: 99%

Serum tryptase and drug hypersensitivity: why, how and what? A systematic review

Klingebiel

Belhocine

Vitte

2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review Serum tryptase, a mast cell marker, provides clues for the mechanism, severity, and management of drug hypersensitivity induced by immunoglobulin E dependent or independent mast cell activation. Recent findings The interpretation of serum tryptase levels has been challenged during the last 2 years by major advances in tryptase genetics and their rapid incorporation into clinical practice. On the contrary, new pathophysiological insight into nonmast cell-dependent immediate hypersensitivity has been gained. Summary This review provides up-to-date information on the pathophysiology and recommended use and interpretation of tryptase in the context of drug hypersensitivity reactions as a function of their endotype.

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The importance of understanding anaphylaxis among older adults

Arroyo

Camargo

2022

Annals of Allergy, Asthma & Immunology

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Anaphylaxis among elderly emergency department patients in a large health system in New York

Cited by 6 publications

References 57 publications

Anaphylaxis in elderly people

Anaphylaxis in elderly people

Serum tryptase and drug hypersensitivity: why, how and what? A systematic review

The importance of understanding anaphylaxis among older adults

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