Mulla et al (BMJ open
2013) sought to determine if chronic pulmonary diseases such as asthma, chronic
obstructive pulmonary disease (COPD),
and cystic fibrosis adversely impacted outcomes in hospitalized patients with various allergic
conditions including anaphylaxis. The
authors used data collected from a statewide hospital discharge database, of
which 2410 individuals had anaphylaxis. Asthmatics were found to have more than
twice the odds of receiving mechanical ventilation and sufferers of chronic
bronchitis and COPD had a prolonged hospitalization stay. The unique analysis of a large database
allowed the authors to determine that chronic pulmonary diseases increased the
risk of adverse outcomes among hospitalized patients with anaphylaxis.
The authors did not
have access to the complete medical records of the patients, how could this
have affected outcomes?
Could there be
anaphylaxis coding inconsistencies in hospital databases especially in patients
with pulmonary disease?
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