@article{3003563,
    title = "Factors increasing the risk for a severe reaction in anaphylaxis: An analysis of data from The European Anaphylaxis Registry",
    author = "Worm, M. and Francuzik, W. and Renaudin, J.-M. and Bilo, M.B. and Cardona, V. and Scherer Hofmeier, K. and Köhli, A. and Bauer, A. and Christoff, G. and Cichocka-Jarosz, E. and Hawranek, T. and Hourihane, J.O.B. and Lange, L. and Mahler, V. and Muraro, A. and Papadopoulos, N.G. and Pföhler, C. and Poziomkowska-Gęsicka, I. and Ruëff, F. and Spindler, T. and Treudler, R. and Fernandez-Rivas, M. and Dölle, S.",
    journal = "Allergy: European Journal of Allergy and Clinical Immunology",
    year = "2018",
    volume = "73",
    number = "6",
    pages = "1322-1330",
    publisher = "Wiley-Blackwell Publishing Ltd",
    doi = "10.1111/all.13380",
    keywords = "acetylsalicylic acid;  allergen;  angiotensin receptor antagonist;  beta adrenergic receptor blocking agent;  dipeptidyl carboxypeptidase inhibitor;  insect venom, adult;  age;  allergic reaction;  anaphylaxis;  Article;  asthma;  bee sting;  child;  cohort analysis;  common cold;  concurrent infection;  disease association;  disease burden;  disease registry;  disease severity;  envenomation;  exercise;  female;  food;  high risk patient;  human;  insect sting;  major clinical study;  male;  mastocytosis;  mental disease;  observational study;  priority journal;  risk factor;  sex;  upper respiratory tract infection;  anaphylaxis;  clinical trial;  comorbidity;  Europe;  health survey;  immunology;  multicenter study;  register;  risk factor;  severity of illness index;  sex factor, Age Factors;  Allergens;  Anaphylaxis;  Comorbidity;  Europe;  Female;  Humans;  Male;  Mastocytosis;  Public Health Surveillance;  Registries;  Risk Factors;  Severity of Illness Index;  Sex Factors",
    abstract = "Background: Preventive measures to decrease the frequency and intensity of anaphylactic events are essential to provide optimal care for allergic patients. Aggravating factors may trigger or increase the severity of anaphylaxis and therefore need to be recognized and avoided. Objective: To identify and prioritize factors associated with an increased risk of developing severe anaphylaxis. Methods: Data from the Anaphylaxis Registry (122 centers in 11 European countries) were used in logistic regression models considering existing severity grading systems, elicitors, and symptoms to identify the relative risk of factors on the severity of anaphylaxis. Results: We identified higher age and concomitant mastocytosis (OR: 3.1, CI: 2.6-3.7) as the most important predictors for an increased risk of severe anaphylaxis. Vigorous physical exercise (OR: 1.5, CI: 1.3-1.7), male sex (OR: 1.2, CI: 1.1-1.3), and psychological burden (OR: 1.4, CI: 1.2-1.6) were more often associated with severe reactions. Additionally, intake of beta-blockers (OR: 1.9, CI: 1.5-2.2) and ACE-I (OR: 1.28, CI: 1.05, 1.51) in temporal proximity to allergen exposition was identified as an important factor in logistic regression analysis. Conclusion: Our data suggest it may be possible to identify patients who require intensified preventive measures due to their relatively higher risk for severe anaphylaxis by considering endogenous and exogenous factors. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd."
}