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Title:Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions
Authors:Hopkins, Philip M. (Author)
Cooke, Peter J. (Author)
Clarke, Russel C. (Author)
Guttormsen, Anne Berit (Author)
Platt, Peter R. (Author)
Dewachter, Pascale (Author)
Ebo, Didier G. (Author)
Garcez, Tomaz (Author)
Garvey, Lene Heise (Author)
Hepner, David L. (Author)
Kopač, Peter (Author)
Language:English
Tipology:1.01 - Original Scientific Article
Organisation:Logo UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
Abstract:Background: Grading schemes for severity of suspected allergic reactions have been applied to the perioperative setting, but there is no scoring system that estimates the likelihood that the reaction is an immediate hypersensitivity reaction. Such a score would be useful in evaluating current and proposed tests for the diagnosis of suspected perioperative immediate hypersensitivity reactions and culprit agents. Methods: We conducted a Delphi consensus process involving a panel of 25 international multidisciplinary experts in suspected perioperative allergy. Items were ranked according to appropriateness (on a scale of 1-9) and consensus, which informed development of a clinical scoring system. The scoring system was assessed by comparing scores generated for a series of clinical scenarios against ratings of panel members. Supplementary scores for mast cell tryptase were generated. Results: Two rounds of the Delphi process achieved stopping criteria for all statements. From an initial 60 statements, 43 were rated appropriate (median score 7 or more) and met agreement criteria (disagreement index <0.5); these were used in the clinical scoring system. The rating of clinical scenarios supported the validity of the scoring system. Although there was variability in the interpretation of changes in mast cell tryptase by the panel, we were able to include supplementary scores for mast cell tryptase. Conclusion: We used a robust consensus development process to devise a clinical scoring system for suspected perioperative immediate hypersensitivity reactions. This will enable objectivity and uniformity in the assessment of the sensitivity of diagnostic tests.
Keywords:alergy and immunology, anesthesia, anaphylaxis, drug hypersensitivity, drug-related side effects and adverse reactions, perioperative period, surgery, operative surgical procedures
Year of publishing:2019
Publisher:Elsevier
Source:Velika Britanija
COBISS_ID:2048509297 Link is opened in a new window
UDC:616-097
ISSN on article:1471-6771
OceCobissID:515369241 Link is opened in a new window
DOI:10.1016/j.bja.2019.02.029 Link is opened in a new window
Note:Soavtor iz Slovenije: P. Kopac; Nasl. z nasl. zaslona; Opis vira z dne 4. 6. 2019;
Views:714
Downloads:186
Files:URL URL - Source URL, visit https://bjanaesthesia.org/article/S0007-0912(19)30191-6/fulltext
 
Journal:Br. j. anaesth.
Oxford University Press.
 
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Rights:© 2019 British Journal of Anaesthesia
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License:Other
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Licensing start date:24.04.2019

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