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http://ir.nhri.org.tw/handle/3990099045/15541
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| Title: | Physician adherence to anaphylaxis guidelines among different age groups in emergency departments: 20-year observational study |
| Authors: | Ho, CH;Lee, HJ;Yeh, YH;Gau, CC;Lim, JW;Juan, YT;Huang, HY;Tsai, HJ;Huang, JL;Yao, TC |
| Contributors: | Institute of Population Health Sciences |
| Abstract: | BACKGROUND: Anaphylaxis is an acute and serious allergic reaction. Little is known about physician adherence to anaphylaxis guidelines among patients across different age groups. OBJECTIVE: To investigate real-world physician adherence to anaphylaxis guidelines among children, adults, and elders in emergency departments. METHODS: This study retrospectively analyzed all consecutive patients with anaphylaxis presented to two emergency departments at two branches of the largest tertiary hospital in Taiwan, from 2001 to 2020. Patients met diagnostic criteria for anaphylaxis were enrolled and grouped by age: children (<18 years), adults (18-64 years), and elders (≥65 years). RESULTS: We enrolled 771 anaphylaxis patients (159 children, 498 adults, and 114 elders). Intramuscular epinephrine was administered in 294 (38.1%) cases. There was a significant age-group difference in rate of intramuscular epinephrine administration (46.5% in children, 37.3% in adults, and 29.8% in elders; p_trend=.004). When stratified by severity, 14.3% of elders with moderate reactions received intramuscular epinephrine, whereas 35.2% of adults and 55.3% of children received intramuscular epinephrine (p_trend<.001), while such difference was not found in patients with severe reactions. Upon discharge from emergency departments, 15.3% received allergist referral (52.2% in children, 6.6% in adults, and 1.8% in elders; p_trend<.001); 12.5% received education on avoidance of triggers (18.9%, 11.4%, and 7.9%; p_trend=.01) and 16.1% received education on alarm symptoms (21.4%, 15.1%, and 13.2%; p_trend=.05). CONCLUSION: The real-world physician adherence to anaphylaxis guidelines remains suboptimal in emergency departments, particularly among elders. Physician continuing education is needed to improve the gap between anaphylaxis guidelines and clinical practice. |
| Date: | 2024-04 |
| Relation: | Annals of Allergy, Asthma and Immunology. 2024 Apr;132(4):519-524.e2. |
| Link to: | http://dx.doi.org/10.1016/j.anai.2023.12.026 |
| JIF/Ranking 2023: | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1081-1206&DestApp=IC2JCR |
| Cited Times(WOS): | https://www.webofscience.com/wos/woscc/full-record/WOS:001264008200002 |
| Cited Times(Scopus): | https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85185509815 |
| Appears in Collections: | [蔡慧如] 期刊論文
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| PUB38151099.pdf | | 1099Kb | Adobe PDF | 85 | View/Open |
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