Incidence of and risk factors for paediatric perioperative anaphylaxis in the USA.

Perioperative anaphylaxis is a serious and often life-threatening immediate hypersensitivity reaction. There are few published data on paediatric perioperative anaphylaxis (pPOA). We evaluated the incidence of and risk factors involved in the occurrence of pPOA within a large US national database. Deidentified data from the US Nationwide Inpatient Sample from 2005 to 2014 were used to identify pPOA cases and to conduct a retrospective multivariate analysis of preselected independent variables. Among 3,601,180 surgeries and procedures in children aged 0–18 yr, 297 pPOA cases were identified for an incidence of one in 12,125 surgeries and procedures. Compared with controls, pPOA cases had an increased median length of stay (6 vs 2 days; P <0.001) and median hospital cost ($54 719 vs $5109; P <0.0001). The age groups between 6 and 12 yr (odds ratio [OR] 7.1; 95% confidence interval [CI] 3.9–12.9; P <0.001) and 13 and 17 yr (OR 8.5; 95% CI 4.7–15.2; P <0.001) were associated with increased odds of pPOA. Transplant (OR 46.3; 95% CI 20.8–102.9; P <0.001), cardiac (OR 16.4; 95% CI 7.5–35.9; P <0.001), and vascular (OR 15.2; 95% CI 7.5–30.7; P <0.001) procedures posed the highest risk for pPOA. Chronic pulmonary disease, coagulopathy, and fluid and electrolyte disorders were also associated with pPOA (OR 2.2; 95% CI 1.5–3.3; P <0.001). The incidence of pPOA was one in 12,125 cases. Risk factors included age, procedure type, and comorbidities. [ABSTRACT FROM AUTHOR]