• Yusuke Okubo, Nobuaki Michihata, Naho Morisaki, Koichi Yoshida, Hiroki Matsui, Kiyohide Fushimi, and Hideo Yasunaga.
• Department of Health Services Research, Graduate School of Medicine, The University of Tokyo.
• Pediatr Emerg Care. 2021 May 1; 37 (5): 255259255-259.

BackgroundThe benefits of glucocorticoid treatment and recent trends of adjunctive treatments during episodes of anaphylaxis remain unclear.ObjectivesThe aims of this study were to investigate the recent practice patterns and compare the effects of glucocorticoid for children hospitalized with anaphylaxis.MethodsUsing the Japanese Diagnosis Procedure Combination inpatient database, we compared the length of hospital stay, risk of 10-day readmission, and total hospitalization cost between the steroid and nonsteroid groups. We also evaluated recent trends of adjunctive treatments for anaphylaxis.ResultsFrom 2010 to 2014, the proportions of H1-receptor antagonist use increased from 65.1% to 71.8% (Ptrend = 0.02). The proportions of H2-receptor antagonist use showed an upward trend, ranging from 12.8% to 16.7% (Ptrend = 0.01). No significant change in glucocorticoid use was observed (from 86.7% to 82.6%; Ptrend = 0.08). Stabilized inverse probability-weighting analyses showed that the total length of hospital stay was 0.39 days longer in the steroid group than in the nonsteroid group (95% confidence interval, 0.29-0.49 days). Total hospitalization cost was greater in the steroid group than in the nonsteroid group (difference, ¥3896; 95% confidence interval, ¥2464-¥5562). No significant difference in risk of 10-day readmission was observed between the groups. Instrumental variable analyses showed similar results to stabilized inverse probability-weighting analyses.ConclusionsWe observed increasing trends of H1- and H2-receptor antagonist use. Length of hospital stay and total hospitalization cost were greater in the steroid group than in the nonsteroid group, whereas readmission risks were similar between the 2 groups.Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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