Role of serum albumin and inflammatory markers in predicting anaphylaxis severity in the emergency department

Purpose: This study investigates whether routinely measured hematological and biochemical parameters can help predict severe anaphylaxis in emergency department (ED) patients. Materials and Methods: This retrospective study analyzed patients diagnosed with anaphylaxis who presented to the ED between 2018 and 2023. Clinical severity was categorized as mild, moderate, or severe. Data included demographic characteristics, clinical findings, and laboratory parameters: serum albumin, C-reactive protein (CRP), hemoglobin, neutrophil-to-lymphocyte ratio, and mean platelet volume to platelet count ratio (MPV/PC). The predictive accuracy of significant variables was assessed through receiver operating characteristic analysis, with corresponding area under the curve (AUC) values reported. Results: Among the 104 patients, 28 (26.9%) were classified as having severe anaphylaxis. The serum albumin concentration was significantly lower in this group (p = 0.004). A cutoff of ≤40.8 g/L yielded an AUC of 0.714 (95% confidence interval: 0.614–0.814), with 85.7% sensitivity and 56.6% specificity. In multivariate analysis, serum albumin, CRP, hemoglobin levels, and the MPV/PC ratio were independently associated with anaphylaxis severity. Conclusion: The findings suggest that serum albumin, a widely accessible and cost-effective laboratory parameter, is associated with severe anaphylaxis and may support risk stratification in ED settings.