20% of patients presenting to the ED with food allergic reactions are admitted

This study from the Massachusetts General Hospital included a medical record review of 1,000 patients that were evaluated at the ED for food-related allergic reactions during 5 years (ICD codes 693.1, 995.0, 995.1, 995.3, 995.7, 995.60-995.69, 558.3, 692.5, and 708.X).

80% of patients were discharged from the ED.

3 factors were associated with a higher likelihood of hospital admission:

- symptoms of food-related anaphylaxis (odds ratio [OR], 2.31)
- pre-ED epinephrine treatment (OR, 6.65)
- epinephrine treatment within 1 hour of ED triage (OR, 3.78)

Patients with food-related allergic reactions triggered by shellfish were less likely to be admitted to the hospital (OR, 0.23).

Most patients presenting to the ED with food-related allergic reactions are discharged.


8 top allergens account for 90 percent of food allergies. Specific IgE levels (sIgE) that predict the likelihood of passing an oral food challenge are shown in the figure. (click to enlarge the image).

References:

Predictors of hospital admission for food-related allergic reactions that present to the emergency department. Banerji A, Rudders SA, Corel B, Garth AP, Clark S, Camargo CA Jr. Ann Allergy Asthma Immunol. 2011 Jan;106(1):42-8.