TABLE 2

Presentation and Clinical Course of Children Who Presented to the ED With a Food-Related Acute Allergic Reaction

Overall (N = 1255), % (95% CI)No Anaphylaxis (N = 597), % (95% CI)Anaphylaxis (N = 658), % (95% CI)aP
Arrive to ED by ambulance34 (30–39)25 (19–32)43 (37–49)<.001
Time since exposure<.001
    <1 h20 (15–24)22 (15–29)17 (12–23)
    1–3 h59 (53–64)51 (42–60)66 (59–72)
    4–6 h9 (6–11)5 (2–9)12 (8–16)
    7–12 h2 (0.4–4)3 (0–6)1 (0.4–1)
    >12 h11 (7–15)18 (11–25)4 (1–7)
Location of exposure.18
    Home70 (65–75)72 (64–80)69 (62–75)
    School/day care12 (8–16)15 (7–21)10 (6–14)
    Restaurant9 (6–13)7 (3–11)11 (6–16)
    Other9 (6–12)7 (3–11)10 (6–14)
Location immediately before ED arrival.001
    Home72 (67–77)77 (69–85)68 (62–73)
    School/day care11 (7–14)13 (7–20)8 (5–12)
    Restaurant3 (1–5)2 (0–4)4 (1–7)
    Doctor's office/clinic5 (3–8)4 (0–9)6 (3–9)
    Outside hospital5 (3–7)2 (0–4)8 (4–11)
    Other4 (2–6)2 (0–4)6 (3–9)
Specific food trigger that caused current reaction
    Peanuts23 (19–27)23 (17–29)23 (18–28).96
    Tree nuts18 (14–22)17 (11–22)19 (15–24).49
    Seeds1 (0–3)02 (0–5)
    Fruits and vegetables11 (8–15)15 (9–20)9 (5–13).07
    Shellfish7 (5–10)8 (4–12)7 (4–10).86
    Fish4 (2–7)5 (1–8)4 (1–7).79
    Food additives1 (0–2)1 (0–3)1 (0–3).91
    Milk products15 (12–19)11 (6–16)19 (14–24).02
    Eggs8 (5–11)12 (6–17)5 (2–7).02
    Wheat1 (0.1–2)1 (0–3)NC
    Other foodb19 (15–23)17 (12–23)21 (15–26).45
Signs and symptoms
    Skin rash76 (72–80)79 (73–85)73 (68–79).18
    Itching33 (28–37)32 (25–39)33 (27–39).80
    Swelling52 (47–57)56 (49–64)48 (42–54).11
    Angioedema3 (2–4)3 (1–6)3 (2–4).76
    Trouble swallowing14 (11–18)NC27 (21–33)
    Trouble breathing/shortness of breath23 (19–26)2 (0.2–4)41 (35–47)<.001
    Wheezing21 (18–25)3 (1–5)38 (32–43)<.001
    Hoarse voice6 (4–8)NC11 (7–16)
    Stridor3 (2–4)NC6 (3–8)
    Nausea/vomiting19 (16–23)2 (0–5)35 (29–41)<.001
    Abdominal pain/cramps3 (2–5)1 (0–2)5 (3–8).01
    DiarrheaNC0NC
    Dizziness/fainting2 (1–3)03 (1–5).004
    Altered mental status1 (0.2–2)02 (0.4–4).02
Organ system involvement
    Respiratory38 (34–43)4 (1–6)70 (64–76)<.001
    Cutaneous93 (91–95)93 (89–97)93 (90–96).84
    Gastrointestinal30 (26–35)2 (0–5)56 (49–62)<.001
    Cardiac3 (1–4)05 (3–8)<.001
  • NC indicates noncalculable.

  • a Anaphylaxis was defined as an allergic reaction involving ≥2 organ systems or hypotension. Hypotension was defined as systolic blood pressure of less than (70 + [age ×2]) for children younger than 10 years and systolic blood pressure of <90 mm Hg for children aged 10 to 18 years.

  • b Other foods included less frequently reported foods (eg, soy or barley) and foods with multiple potential allergens (eg, cookies or pizza).