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TOPLINE:

Older adults who present to the emergency department (ED) with anaphylaxis may be more likely than younger adults to be hospitalized and to have medications or intravenous contrast as triggers, a study showed. Older patients also may be less likely to receive epinephrine from emergency medical services (EMS).

METHODOLOGY:

• Researchers examined data from ED visits for anaphylaxis at one center from April 2008 through December 2022 to compare adults aged 65 years or older and younger adults.
• Of 1422 patient visits, 1210 were from younger adults (median age, 39 years; 65% women) and 212 were from older adults (median age, 73 years; 54.7% women).

TAKEAWAY:

• Older adults were more likely than younger adults to have medication (odds ratio [OR], 1.85; P < .001) or intravenous contrast (OR, 2.50; P < .001) as suspected triggers. Food triggers were less common in the older group (OR, 0.41; P < .001).
• Older adults were more likely to arrive via EMS (OR, 2.56; P < .001) but less likely to receive EMS-administered epinephrine (adjusted OR [aOR], 0.46; P = .003).
• Severe anaphylaxis involving endotracheal intubation; admission to the hospital or ICU; or syncope, hypotension, or hypoxemia was more likely in older patients (aOR, 1.57; P = .009).

IN PRACTICE:

“Improved education is needed to enhance anaphylaxis recognition and timely epinephrine use in older adults,” the authors of the study wrote. “Given their higher risk of severe reactions, multidisciplinary guidelines should support proper outpatient follow-up and self-injectable epinephrine prescriptions after ED visits or hospitalization.”

SOURCE:

Ronna L. Campbell, MD, PhD, with Mayo Clinic, Rochester, Minnesota, was the corresponding author of the study, which was published online on April 22 in The Journal of Allergy and Clinical Immunology: In Practice.

LIMITATIONS:

The study had a retrospective design, relied on electronic health records, and was conducted at a single tertiary center with a predominantly White population. 

DISCLOSURES:

The research was supported in part by the Mayo Clinic Summer Research Fellowship Program. Campbell declared consulting for Bryn Pharma. A coauthor reported receiving funding from federal agencies and Diagnostic Robotics.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.