Food, drug, insect sting allergy, and anaphylaxisCase fatality and population mortality associated with anaphylaxis in the United States
Section snippets
Data sources
Three separate databases were used in this study: the Nationwide Inpatient Sample (NIS; 1999-2009), the Nationwide Emergency Department Sample (NEDS; 2006-2009), and Multiple Cause of Death Data (MCDD; 1999-2009).19, 20, 21 These databases are deidentified for public use and were protected through data use agreements.
Anaphylaxis-related hospitalizations and inpatient deaths (NIS)
Between 1999 and 2009, the annual number of anaphylaxis-related hospitalizations increased from 5681 to 7708 (Table I), which corresponds to an increase in hospitalization rates from 21.0 to 25.1 per million population (Fig 1), with an annual increase of approximately 2.23% (95% CI, 1.52% to 2.94%; P < .01). In contrast, the case fatality rate among hospitalizations for anaphylaxis appeared to be decreasing, with an annual change of −2.35% (95% CI, −4.98% to 0.34%; P = .09). Case fatality rates
Discussion
There are many aspects of an anaphylactic reaction that make it frightening to both patients and health care providers, including rapidity of onset and potential for fatality. Because the onset of symptoms can occur rapidly and outside the health care setting, patients who have had anaphylactic reactions need to remain vigilant to try to prevent re-exposure to the causative allergen. Sometimes avoidance is not possible because the patient cannot prevent the exposure (eg, insect sting), the
References (38)
- et al.
Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium
J Allergy Clin Immunol
(2006) - et al.
Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003
J Allergy Clin Immunol
(2004) Anaphylaxis
J Allergy Clin Immunol
(2010)- et al.
Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group
Ann Allergy Asthma Immunol
(2006) - et al.
Epidemiology of anaphylaxis in Olmsted County: a population-based study
J Allergy Clin Immunol
(1999) - et al.
Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization
J Allergy Clin Immunol
(2004) - et al.
Increasing anaphylaxis hospitalizations in the first 2 decades of life: New York State, 1990-2006
Ann Allergy Asthma Immunol
(2008) - et al.
Increasing hospitalizations due to angioedema in the United States
Ann Allergy Asthma Immunol
(2008) - et al.
Emergency department care in the United States: a profile of national data sources
Ann Emerg Med
(2010) - et al.
Anaphylaxis: past, present and future
Allergy
(2011)
Anaphylaxis
Allergy Asthma Clin Immunol
Anaphylaxis: mechanisms and management
Clin Exp Allergy
Epidemiology of anaphylaxis in the United States
Curr Allergy Asthma Rep
Epidemiology of life-threatening and lethal anaphylaxis: a review
Allergy
Anaphylaxis in children: a 5-year experience
Pediatrics
A population-based epidemiologic analysis of deaths from anaphylaxis in Florida
Allergy
Hospitalizations for anaphylaxis in Florida: epidemiologic analysis of a population-based dataset
Int Arch Allergy Immunol
Anaphylaxis in the United States: an investigation into its epidemiology
Arch Intern Med
Perspectives on anaphylaxis epidemiology in the United States with new data and analyses
Curr Allergy Asthma Rep
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Supported by Endo Pharmaceuticals Inc (Malvern, Pa). L.B. receives his salary from the National Institutes of Health (RO1 AI1057438 and UO1 AI100799).
Disclosure of potential conflict of interest: L. Ma is employed by Endo Pharmaceuticals and receives stock as part of his compensation. T. M. Danoff was employed by Endo Pharmaceuticals at the time of this work and received stock as part of his compensation. L. Borish has consultant arrangements with Endo Pharmaceuticals.