ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN PHẢN VỆ QUANH PHẪU THUẬT

Abstract

Objectives: To describe the clinical and laboratory characteristics and evaluate the treatment outcomes of patients with perioperative anaphylaxis (PA). Methods: A retrospective, descriptive study was conducted on 64 patients diagnosed with perioperative anaphylaxis between January 2020 and June 2025 at 108 Military Central Hospital. Data, including demographics, onset timing, suspected agents, clinical manifestations, laboratory tests, SOFA score, management interventions, and outcomes, were collected. Descriptive analysis and mortality prediction using ROC curves were performed. Results: The mean age was 57.4 ± 6.6 years; 60.9% were male. PA occurred predominantly during surgery (45.3%) or at induction of anesthesia (41.2%). Grade III and grade IV anaphylaxis accounted for 75% and 12.5% of cases, respectively. Suspected agents were antibiotics (51.6%) and neuromuscular blocking agents (31.3%). Cardiovascular and respiratory manifestations were the most frequent (occurring in 85.9% and 76.6%, respectively). The overall mortality was 3.13% (2/64), with both deaths in grade IV. Lactate levels and SOFA score showed the highest predictive value for mortality (AUC lactate = 0.937, p = 0.004; AUC SOFA = 0.888, p = 0.010). Conclusion: Perioperative anaphylaxis is most commonly associated with antibiotics and neuromuscular blocking agents, occurring predominantly during anesthesia induction or surgery. Initial elevations in lactate levels and SOFA scores at baseline are closely associated with poor prognosis. Early detection, timely adrenaline administration, adequate fluid resuscitation, and monitoring of lactate levels and SOFA scores are highly recommended.