Müge ERBAY, Aleyna BEKTAŞ HOCEK
Journal of Medicine and Palliative Care - 2026;7(3):615-620
Aims: This study aimed to evaluate the clinical characteristics, etiological distribution, and predictors of severe anaphylaxis in adult patients. Methods: This single-center retrospective cohort study included adult patients (>=18 years) diagnosed with anaphylaxis between May 2023 and March 2026. Anaphylaxis severity was classified according to national guidelines. Results: A total of 195 patients were included (median age: 44 years; 66.2% female), and 20.5% were aged >=60 years. Severe anaphylaxis accounted for 53.8% of cases. Drugs were the most common trigger (65.6%), followed by venom (30.8%). Cutaneous symptoms were the most common manifestations, with urticaria observed in 62.6% and pruritus in 53.8% of patients. Hypertension was significantly more common in severe cases (p=0.03), while malignancy was more frequent in non-severe cases (p=0.02). Antibiotics, local anesthetics, and general anesthetics were associated with severe reactions. In univariable analysis, increasing age (OR: 1.02), antibiotic-induced anaphylaxis (OR: 2.27), and hypertension (OR: 2.19) were associated with severe anaphylaxis, whereas malignancy was inversely associated (OR: 0.33). In multivariable logistic regression analysis, none of the variables were independently associated with severe anaphylaxis. Epinephrine was administered in 62.4% of patients. Conclusion: Drug-induced anaphylaxis is the predominant trigger in adults. Older age, hypertension, and antibiotic-induced reactions were more common among patients with severe anaphylaxis in unadjusted analyses; however, no independent predictors of severe anaphylaxis were identified. Despite guideline recommendations, epinephrine use remains suboptimal, highlighting the need for improved adherence to acute management protocols.
