Role of serum albumin and inflammatory markers in predicting anaphylaxis severity in the emergency department
Öz
Purpose: This study investigates whether routinely measured hematological and biochemical parameters can help predict severe anaphylaxis in emergency department (ED) patients. Materials and Methods: This retrospective study analyzed patients diagnosed with anaphylaxis who presented to the ED between 2018 and 2023. Clinical severity was categorized as mild, moderate, or severe. Data included demographic characteristics, clinical findings, and laboratory parameters: serum albumin, C-reactive protein (CRP), hemoglobin, neutrophil-to-lymphocyte ratio, and mean platelet volume to platelet count ratio (MPV/PC). The predictive accuracy of significant variables was assessed through receiver operating characteristic analysis, with corresponding area under the curve (AUC) values reported. Results: Among the 104 patients, 28 (26.9%) were classified as having severe anaphylaxis. The serum albumin concentration was significantly lower in this group (p = 0.004). A cutoff of ≤40.8 g/L yielded an AUC of 0.714 (95% confidence interval: 0.614–0.814), with 85.7% sensitivity and 56.6% specificity. In multivariate analysis, serum albumin, CRP, hemoglobin levels, and the MPV/PC ratio were independently associated with anaphylaxis severity. Conclusion: The findings suggest that serum albumin, a widely accessible and cost-effective laboratory parameter, is associated with severe anaphylaxis and may support risk stratification in ED settings.
Anahtar Kelimeler
anaphylaxis, biomarkers, serum albumin, emergency department, risk assessment
Destekleyen Kurum
Etik Beyan
Teşekkür
Kaynakça
- Antolín-Amérigo D, Vidal-Albareda C, González de Olano D, de la Hoz-Caballer B. Current update on anaphylaxis: anaphylaxis management in recent guidelines. Eur Ann Allergy Clin Immunol. 2024;56:51-64.
- Burnell FJ, Keijzers G, Smith P. Quality of follow‐up care for anaphylaxis in the emergency department. Emerg Med Australas. 2015;27:387-93.
- Kim SY, Kim MH, Cho YJ. Different clinical features of anaphylaxis according to cause and risk factors for severe reactions. Allergol Int. 2018;67:96-102.
- Yu JE, Lin RY. The epidemiology of anaphylaxis. Clin Rev Allergy Immunol. 2018;54:366-74.
- Dribin TE, Motosue MS, Campbell RL. Overview of allergy and anaphylaxis. Emerg Med Clin North Am. 2022;40:1–17.
- Casas-Saucedo R, de la Cruz C, Araujo-Sánchez G, Gelis S, Jimenez T, Riggioni S et al. Risk factors in severe anaphylaxis: which matters the most, food or cofactors? J Investig Allergol Clin Immunol. 2022;32:282–90.
- Bulut İ, Yegin Katran Z, Yavuz D. Anaphylaxis in a country where Asia and Europe meet: evaluation according to World Allergy Organization (WAO) and European Academy of Allergy and Clinical Immunology (EAACI) diagnostic criteria. World Allergy Organ J. 2024;17:100962.
- Whyte AF, Soar J, Dodd A, Hughes A, Sargant N, Turner PJ. Emergency treatment of anaphylaxis: concise clinical guidance. Clin Med (Lond). 2022;22:332-39.
- Golden DBK, Wang J, Waserman S, Akin C, Campbell RL, Ellis AK et al. Anaphylaxis: a 2023 practice parameter update. Ann Allergy Asthma Immunol. 2024;132:124–76.
- Galvan-Blasco P, Gil-Serrano J, Sala-Cunill A. New biomarkers in anaphylaxis (beyond tryptase). Curr Treat Options Allergy. 2022;9:303-22.
