Trends in Emergency Department Visits and Hospitalizations for Acute Allergic Reactions and Anaphylaxis Among US Older Adults: 2006-2014

Arroyo, Anna Chen; Robinson, Lacey B.; Cash, Rebecca E.; Faridi, Mohammad Kamal; Hasegawa, Kohei; Camargo, Carlos A.

doi:10.1016/j.jaip.2021.03.032

Cited by 12 publications

(12 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

See 1 more Smart Citation

Anaphylaxis in elderly people

Ventura

Boni²,

Taborda-Barata

et al. 2022

Current Opinion in Allergy &Amp; Clinical Immunology

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Older adults have been noted to have increased risk of fatal anaphylaxis, especially secondary to drug-related anaphylaxis. 10 Documented epinephrine use was noted to be low perhaps secondary to prehospital use or inadequate documentation.…”

mentioning

confidence: 99%

Emergency department visits for vaccine-related severe allergic reactions among US adults: 2006-2018

Arroyo

Robinson

Cash

et al. 2022

Annals of Allergy, Asthma & Immunology

Self Cite

View full text Add to dashboard Cite

“…Although the mechanism, potential triggers, and clinical management of anaphylaxis have been extensively studied in both children and adults, 1 few studies have specifically focused on older adults (≥65 years). 2,3 Older adults are a rapidly growing segment of the US population, with 54.1 million persons today and a projected 94.7 million in 2060. 4 Older adults are a unique "vulnerable population" because they often have multiple comorbidities, including cardiovascular disease, that may complicate anaphylaxis management and lead to poor outcomes.…”

mentioning

confidence: 99%

“…6 Although anaphylaxisrelated Emergency Department (ED) visit and hospitalization rates are increasing over time for older adults, limited data have also shown underutilization of epinephrine, the first-line treatment for anaphylaxis. 3,7,8 The study by Meir et al 9 in this issue of Annals of Allergy, Asthma & Immunology considerably adds to the existing literature in this field because the authors examined detailed clinical and management characteristics of older adults presenting with anaphylaxis to EDs from a large New York healthcare system. Using National Institutes of Allergy and Infectious Disease criteria for anaphylaxis ascertainment and extensive chart review, the authors identified 82 older adults who met criteria for anaphylaxis, with the most commonly identified triggers from radiocontrast and antibiotics.…”

mentioning

confidence: 99%