Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children
Abstract Background The initial episode of angioedema in children can be potential life-threatening due to the lack of prompt identification and treatment. We aimed to analyze the factors predicting the severity and outcomes of the first attack of acute angioedema in children. Methods This was a ret...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12887-019-1809-8 |
| _version_ | 1818263235099361280 |
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| author | Yuan-Jhen Syue Chao-Jui Li Wen-Liang Chen Tsung-Han Lee Cheng-Chieh Huang Mei-Chueh Yang Chih-Ming Lin Meng-Huan Wu Chu-Chung Chou Chin-Fu Chang Yan-Ren Lin |
| author_facet | Yuan-Jhen Syue Chao-Jui Li Wen-Liang Chen Tsung-Han Lee Cheng-Chieh Huang Mei-Chueh Yang Chih-Ming Lin Meng-Huan Wu Chu-Chung Chou Chin-Fu Chang Yan-Ren Lin |
| author_sort | Yuan-Jhen Syue |
| collection | DOAJ |
| description | Abstract Background The initial episode of angioedema in children can be potential life-threatening due to the lack of prompt identification and treatment. We aimed to analyze the factors predicting the severity and outcomes of the first attack of acute angioedema in children. Methods This was a retrospective study with 406 children (< 18 years) who presented in the emergency department (ED) with an initial episode of acute angioedema and who had subsequent follow-up visits in the out-patient department from January 2008 to December 2014. The severity of the acute angioedema was categorized as severe (requiring hospital admission), moderate (requiring a stay in the short-term pediatric observation unit [POU]), or mild (discharged directly from the ED). The associations among the disease severity, patient demographics and clinical presentation were analyzed. Result In total, 109 (26.8%) children had severe angioedema, and the majority of those children were male (65.1%). Most of the children were of preschool age (56.4%), and only 6.4% were adolescents. The co-occurrence of pyrexia or urticaria, etiologies of the angioedema related to medications or infections, the presence of respiratory symptoms, and a history of allergies (asthma, allergic rhinitis) were predictors of severe angioedema (all p < 0.05). Finally, the duration of angioedema was significantly shorter in children who had received short-term POU treatment (2.1 ± 1.1 days) than in those who discharged from ED directly (2.3 ± 1.4 days) and admitted to the hospital (3.5 ± 2.0 days) (p < 0.001). Conclusion The co-occurrence of pyrexia or urticaria, etiologies related to medications or infections, the presence of respiratory symptoms, and a history of allergies were predictors of severe angioedema. More importantly, short-term POU observation and prompt treatment might be benefit for patients who did not require hospital admission. |
| first_indexed | 2024-12-12T19:15:47Z |
| format | Article |
| id | doaj.art-9135f20994a641e5b467fbee9dcd3749 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-12T19:15:47Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-9135f20994a641e5b467fbee9dcd37492022-12-22T00:14:44ZengBMCBMC Pediatrics1471-24312019-11-011911910.1186/s12887-019-1809-8Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in childrenYuan-Jhen Syue0Chao-Jui Li1Wen-Liang Chen2Tsung-Han Lee3Cheng-Chieh Huang4Mei-Chueh Yang5Chih-Ming Lin6Meng-Huan Wu7Chu-Chung Chou8Chin-Fu Chang9Yan-Ren Lin10Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Biological Science and Technology, National Chiao Tung UniversityDepartment of Biological Science and Technology, National Chiao Tung UniversityDepartment of Biological Science and Technology, National Chiao Tung UniversityDepartment of Emergency Medicine, Changhua Christian HospitalDepartment of Neurology, Changhua Christian HospitalDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Emergency Medicine, Changhua Christian HospitalDepartment of Emergency Medicine, Changhua Christian HospitalDepartment of Emergency Medicine, Changhua Christian HospitalAbstract Background The initial episode of angioedema in children can be potential life-threatening due to the lack of prompt identification and treatment. We aimed to analyze the factors predicting the severity and outcomes of the first attack of acute angioedema in children. Methods This was a retrospective study with 406 children (< 18 years) who presented in the emergency department (ED) with an initial episode of acute angioedema and who had subsequent follow-up visits in the out-patient department from January 2008 to December 2014. The severity of the acute angioedema was categorized as severe (requiring hospital admission), moderate (requiring a stay in the short-term pediatric observation unit [POU]), or mild (discharged directly from the ED). The associations among the disease severity, patient demographics and clinical presentation were analyzed. Result In total, 109 (26.8%) children had severe angioedema, and the majority of those children were male (65.1%). Most of the children were of preschool age (56.4%), and only 6.4% were adolescents. The co-occurrence of pyrexia or urticaria, etiologies of the angioedema related to medications or infections, the presence of respiratory symptoms, and a history of allergies (asthma, allergic rhinitis) were predictors of severe angioedema (all p < 0.05). Finally, the duration of angioedema was significantly shorter in children who had received short-term POU treatment (2.1 ± 1.1 days) than in those who discharged from ED directly (2.3 ± 1.4 days) and admitted to the hospital (3.5 ± 2.0 days) (p < 0.001). Conclusion The co-occurrence of pyrexia or urticaria, etiologies related to medications or infections, the presence of respiratory symptoms, and a history of allergies were predictors of severe angioedema. More importantly, short-term POU observation and prompt treatment might be benefit for patients who did not require hospital admission.http://link.springer.com/article/10.1186/s12887-019-1809-8AngioedemaChildrenFirst attackUrticariaAllergyEpinephrine |
| spellingShingle | Yuan-Jhen Syue Chao-Jui Li Wen-Liang Chen Tsung-Han Lee Cheng-Chieh Huang Mei-Chueh Yang Chih-Ming Lin Meng-Huan Wu Chu-Chung Chou Chin-Fu Chang Yan-Ren Lin Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children BMC Pediatrics Angioedema Children First attack Urticaria Allergy Epinephrine |
| title | Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children |
| title_full | Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children |
| title_fullStr | Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children |
| title_full_unstemmed | Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children |
| title_short | Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children |
| title_sort | significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children |
| topic | Angioedema Children First attack Urticaria Allergy Epinephrine |
| url | http://link.springer.com/article/10.1186/s12887-019-1809-8 |
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