P290 - Anaphylaxie aux urgences: facteurs de risque associés aux états de choc

Mouna Gammoudi (1), Hanen Ghazali (1), Rym Kaddour (1), Mohamed Mguidich (2), Anware Yahmadi (3), Ahlem Azouzi (1), Ali Ben Yahya (1), Sami Souissi (4)

1. service d'acceuil des urgences, Hôpital Régional de Ben Arous, Ben Arous, Tunisie 2. service d'acceuil des urgences, Hôpital Régional de Ben Arous, Ben Arous, France 3. service d'acceuil des urgences, Hôpital Régional de Ben Arous, ben Arous, France 4. Service d'Accueil des Urgences, Hôpital Régional de Ben Arous, Ben Arous, Tunisie

Diffusion le 06/12/2015

/medias/images/design/icos/eposters.png


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Introduction: L’anaphylaxie est une réaction systémique grave qui s’inscrit dans le cadre général des réactions d’hypersensibilité potentiellement fatale nécessitant une prise en charge immédiate (Simpson et al 2006).
Objectif : Etudier les caractéristiques cliniques et les facteurs de risque associés au choc chez les patients se présentant aux urgences pour anaphylaxie.
Méthodologie: Etude prospective menée sur 2ans. Inclusion des patients dont le diagnostic d'anaphylaxie a été retenu selon les critères définis par Simpson. Division des patients en 2 groupes: groupe1(G1): patients présentant un choc anaphylactique défini par une pression artérielle systolique <90 mmHg nécessitant le recours à l’adrénaline intraveineuse et groupe2 (G2): patients sans choc. Une analyse multivariée a été réalisée pour identifier les facteurs de risques associés au choc.
Résultats: Inclusion de 239  patients. Age moyen = 39 ± 15 ans. Sex ratio = 0,83. Cent vingt-quatre patients ont été inclus dans le G1 contre 115 dans le G2. Les caractéristiques démographiques étaient comparables. L’analyse multivariée a identifié 5 facteurs de risque associés au choc (tableau).
Conclusion: Les antécédents d’anaphylaxie, le délai d’apparition des symptômes jusqu’à la consultation (DSC), la prise d’antibiotiques, la voie parentérale et les signes neurologiques sont des facteurs de risque de choc. Leur reconnaissance précoce est primordiale pour une meilleure prise en charge dans les services d’urgence.


\n
\n

Facteurs

OR ajusté

IC95%

P

Antécédents d’anaphylaxie

1,35

[1,03 ; 1,77]

0,02

DSC=68 min                       

2,5

   [1,4 ; 4,7]

0,002

 

Prise ATB

1,38

[1,04 ; 1,82]

0,02

Voie parentérale

2,27

[1,03 ; 4,97]

0.04

Signes neurologiques

2,23

[1,5 ; 4,77]

0.02

Tags : anaphylaxie choc service des urgences

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/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Controller/Router/Rewrite.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Controller/Router/Route.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Controller/Router/Route/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Controller/Router/Route/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Controller/Router/Route/Module.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Controller/Router/Route/Static.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Date.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Date/DateObject.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Adapter/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Adapter/Pdo/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Adapter/Pdo/Mysql.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Expr.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Profiler.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Select.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Statement.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Statement/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Statement/Pdo.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Table.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Table/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Db/Table/Definition.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Exception.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/Inflector.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/PregReplace.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/StringToLower.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/Word/CamelCaseToDash.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/Word/CamelCaseToSeparator.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/Word/Separator/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/Word/SeparatorToSeparator.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Filter/Word/UnderscoreToSeparator.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Layout.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Layout/Controller/Action/Helper/Layout.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Layout/Controller/Plugin/Layout.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Loader.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Loader/Autoloader.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Loader/PluginLoader.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Loader/PluginLoader/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Locale.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Locale/Data.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Locale/Format.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Locale/Math.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Log.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Log/FactoryInterface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Log/Filter/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Log/Filter/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Log/Filter/Priority.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Log/Writer/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Registry.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Session.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Session/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Session/Exception.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Session/Namespace.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Session/SaveHandler/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Uri.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/Version.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Doctype.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/HeadMeta.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/HeadTitle.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Layout.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Placeholder/Container.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Placeholder/Container/Abstract.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Placeholder/Container/Standalone.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Placeholder/Registry.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Helper/Url.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/Zend/View/Interface.php

ZFDebug Files

/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Cache.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Database.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Exception.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/File.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Interface.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Log.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Log/Writer.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Text.php
/var/www/vhosts/urgencesdirectinfo.com/sub/v3/httpdocs/library/ZFDebug/Controller/Plugin/Debug/Plugin/Variables.php