Identifying key risk factors for severe pediatric anaphylaxis in children aged 0 to 15: Evidence from a Thai study

Background: Anaphylaxis is a life-threatening condition with significant global health implications. Understanding its risk factors in children across diverse populations is crucial for effective prevention and management strategies. Objective: The aim is to identify risk factors for severe anaphylaxis in children, using data from a Southeast Asian population. Methods: A retrospective study was conducted at a tertiary care hospital, Thailand, from 2015 to 2023. Data from 335 pediatric patients with anaphylaxis, classified into severe and nonsevere groups, were analyzed. Risk factors were identified using multivariable logistic regression. Results: Severe anaphylaxis occurred in 24 patients (7.2%). Males (58%) and food allergens, particularly shellfish and wheat, were the predominant factors. Severe cases were associated with an age greater than 12 years (adjusted odds ratio [aOR]: 5.67, P < 0.05), cardiovascular manifestations (aOR: 129.94, P < 0.01), and an early onset of symptoms (aOR: 0.96, P < 0.05). Conclusion: Age >12 years, cardiovascular symptoms, and early symptom onset were significant risk factors for severe anaphylaxis in children. These findings highlight the need for heightened vigilance and tailored management strategies in older children and those with cardiovascular involvement. Future studies in diverse populations are needed to confirm the generalizability of these risk factors.