Emergency Department Utilization in Patients With Chronic Spontaneous Urticaria Followed at a Tertiary Referral Center: A Retrospective Cross-Sectional Study
Dermatologic Therapy, cilt.2026, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 2026 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1155/dth/9077043
- Dergi Adı: Dermatologic Therapy
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: angioedema, chronic spontaneous urticaria, consultation, emergency department, healthcare utilization, omalizumab
- İstanbul Kent Üniversitesi Adresli: Evet
Özet
Background: Chronic spontaneous urticaria (CSU) frequently prompts emergency department (ED) visits, but few studies have characterized this utilization in a defined dermatology cohort under contemporary anti-IgE therapy. Objective: To quantify ED utilization, identify factors associated with prior ED visits, and describe the pattern of ED-initiated dermatology consultation in adult CSU patients at a tertiary referral center. Methods: Retrospective cross-sectional analysis of 195 adult patients with physician-diagnosed CSU at a single tertiary dermatology clinic between June 1, 2025, and December 31, 2025. Three operational ED utilization rates were estimated. Patients with at least one prior ED visit were compared with patients without, and a multivariable logistic regression model was constructed. Results: Median age was 43 years (Q1–Q3: 36–51); 66.2% were female; angioedema was reported in 24.1% and omalizumab prescribed in 97.9%. The ED served as the initial point of contact in 5.1% (95% confidence interval [CI]: 2.8%–9.2%); 45.1% (95% CI: 38.3%–52.1%) had any prior ED visit and 26.2% (95% CI: 20.5%–32.7%) had recurrent visits. Among ED users, antihistamines were administered in 93.2% and systemic corticosteroids in 59.1%, while ED-initiated dermatology consultation was documented in only 8.0% (95% CI: 3.9%–15.5%). In multivariable analysis, concomitant angioedema was independently associated with prior ED utilization (adjusted OR: 3.99, 95% CI: 1.93–8.69, p < 0.001); identifiable trigger was inversely associated (adjusted OR: 0.36, 95% CI: 0.14–0.88, p = 0.025). Conclusions: Even though omalizumab had been prescribed in 97.9% of the patients, almost half had attended the ED and consultation occurred in fewer than one in ten ED users. Concomitant angioedema independently predicts ED utilization, and ED encounters represent a missed integration point in CSU longitudinal care.