Increase in anaphylaxis-related hospitalizations but no increase in fatalities: An analysis of United Kingdom national anaphylaxis data, 1992-2012

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:135

Article

Turner, Paul J.^1,2,3,4  Gowland, M. Hazel⁵  Sharma, Vibha⁶  Ierodiakonou, Despo^1,2,3  Harper, Nigel⁶  Garcez, Tomaz⁶  Pumphrey, Richard⁶  Boyle, Robert J.^1,2,3 

[1] Univ London Imperial Coll Sci Technol & Med, Sect Paediat Allergy & Immunol, London W2 1NY, England

[2] Univ London Imperial Coll Sci Technol & Med, MRC, London W2 1NY, England

[3] Univ London Imperial Coll Sci Technol & Med, Asthma UK Ctr Allerg Mech Asthma, London W2 1NY, England

[4] Univ Sydney, Div Paediat & Child Hlth, Sydney, NSW 2006, Australia

[5] Allergy Act & Anaphylaxis Campaign UK, Farnborough, Hants, England

[6] Cent Manchester Univ Hosp NHS Fdn Trust, Manchester, Lancs, England

关键词: Anaphylaxis;    drug allergy;    epidemiology;    food allergy;    hospitalization;    insect sting allergy;   

DOI  :  10.1016/j.jaci.2014.10.021

来源: Elsevier

【 摘 要 】

Background: The incidence of anaphylaxis might be increasing. Data for fatal anaphylaxis are limited because of the rarity of this outcome. Objective: We sought to document trends in anaphylaxis admissions and fatalities by age, sex, and cause in England and Wales over a 20-year period. Methods: We extracted data from national databases that record hospital admissions and fatalities caused by anaphylaxis in England and Wales (1992-2012) and crosschecked fatalities against a prospective fatal anaphylaxis registry. We examined time trends and age distribution for fatal anaphylaxis caused by food, drugs, and insect stings. Results: Hospital admissions from all-cause anaphylaxis increased by 615% over the time period studied, but annual fatality rates remained stable at 0.047 cases (95% CI, 0.042-0.052 cases) per 100,000 population. Admission and fatality rates for drug-and insect sting-induced anaphylaxis were highest in the group aged 60 years and older. In contrast, admissions because of food-triggered anaphylaxis were most common in young people, with a marked peak in the incidence of fatal food reactions during the second and third decades of life. These findings are not explained by age-related differences in rates of hospitalization. Conclusions: Hospitalizations for anaphylaxis increased between 1992 and 2012, but the incidence of fatal anaphylaxis did not. This might be due to increasing awareness of the diagnosis, shifting patterns of behavior in patients and health care providers, or both. The age distribution of fatal anaphylaxis varies significantly according to the nature of the eliciting agent, which suggests a specific vulnerability to severe outcomes from food-induced allergic reactions in the second and third decades.

【 授权许可】

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