Fatal anaphylaxis in the United States, 1999-2010: Temporal patterns and demographic associations

Elina Jerschow, Robert Y. Lin, Moira M. Scaperotti, Aileen P. McGinn

Research output: Contribution to journalArticle

140 Citations (Scopus)

Abstract

Results There were a total of 2458 anaphylaxis-related deaths in the United States from 1999 to 2010. Medications were the most common cause (58.8%), followed by "unspecified" (19.3%), venom (15.2%), and food (6.7%). There was a significant increase in fatal drug-induced anaphylaxis over 12 years: from 0.27 (95% CI, 0.23-0.30) per million in 1999 to 2001 to 0.51 (95% CI, 0.47-0.56) per million in 2008 to 2010 (P <.001). Fatal anaphylaxis caused by medications, food, and unspecified allergens was significantly associated with African American race and older age (P <.001). Fatal anaphylaxis to venom was significantly associated with white race, older age, and male sex (P <.001). The rates of fatal anaphylaxis to foods in male African American subjects increased from 0.06 (95% CI, 0.01-0.17) per million in 1999 to 2001 to 0.21 (95% CI, 0.11-0.37) per million in 2008 to 2010 (P <.001). The rates of unspecified fatal anaphylaxis decreased over time from 0.30 (95% CI, 0.26-0.34) per million in 1999 to 2001 to 0.09 (95% CI, 0.07-0.11) per million in 2008 to 2010 (P <.001).

Conclusion There are strong and disparate associations between race and specific classes of anaphylaxis-related mortality in the United States. The increase in medication-related deaths caused by anaphylaxis likely relates to increased medication and radiocontrast use, enhanced diagnosis, and coding changes.

MethodsAnaphylaxis-related deaths were identified by using the 10th clinical modification of the International Classification of Diseases system diagnostic codes on death certificates from the US National Mortality Database. Rates were calculated by using census population estimates.

Background Anaphylaxis-related deaths in the United States have not been well characterized in recent years. Objectives We sought to define epidemiologic features and time trends of fatal anaphylaxis in the United States from 1999 to 2010.

Original languageEnglish (US)
Pages (from-to)1318-1328.e7
JournalJournal of Allergy and Clinical Immunology
Volume134
Issue number6
DOIs
StatePublished - Dec 1 2014

Fingerprint

Anaphylaxis
Demography
Venoms
Food
African Americans
Death Certificates
Mortality
International Classification of Diseases
Censuses
Allergens
Databases

Keywords

  • death certificate
  • drug
  • epidemiology
  • Fatal anaphylaxis
  • food
  • venom

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Fatal anaphylaxis in the United States, 1999-2010 : Temporal patterns and demographic associations. / Jerschow, Elina; Lin, Robert Y.; Scaperotti, Moira M.; McGinn, Aileen P.

In: Journal of Allergy and Clinical Immunology, Vol. 134, No. 6, 01.12.2014, p. 1318-1328.e7.

Research output: Contribution to journalArticle

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abstract = "Results There were a total of 2458 anaphylaxis-related deaths in the United States from 1999 to 2010. Medications were the most common cause (58.8{\%}), followed by {"}unspecified{"} (19.3{\%}), venom (15.2{\%}), and food (6.7{\%}). There was a significant increase in fatal drug-induced anaphylaxis over 12 years: from 0.27 (95{\%} CI, 0.23-0.30) per million in 1999 to 2001 to 0.51 (95{\%} CI, 0.47-0.56) per million in 2008 to 2010 (P <.001). Fatal anaphylaxis caused by medications, food, and unspecified allergens was significantly associated with African American race and older age (P <.001). Fatal anaphylaxis to venom was significantly associated with white race, older age, and male sex (P <.001). The rates of fatal anaphylaxis to foods in male African American subjects increased from 0.06 (95{\%} CI, 0.01-0.17) per million in 1999 to 2001 to 0.21 (95{\%} CI, 0.11-0.37) per million in 2008 to 2010 (P <.001). The rates of unspecified fatal anaphylaxis decreased over time from 0.30 (95{\%} CI, 0.26-0.34) per million in 1999 to 2001 to 0.09 (95{\%} CI, 0.07-0.11) per million in 2008 to 2010 (P <.001).Conclusion There are strong and disparate associations between race and specific classes of anaphylaxis-related mortality in the United States. The increase in medication-related deaths caused by anaphylaxis likely relates to increased medication and radiocontrast use, enhanced diagnosis, and coding changes.MethodsAnaphylaxis-related deaths were identified by using the 10th clinical modification of the International Classification of Diseases system diagnostic codes on death certificates from the US National Mortality Database. Rates were calculated by using census population estimates.Background Anaphylaxis-related deaths in the United States have not been well characterized in recent years. Objectives We sought to define epidemiologic features and time trends of fatal anaphylaxis in the United States from 1999 to 2010.",
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T1 - Fatal anaphylaxis in the United States, 1999-2010

T2 - Temporal patterns and demographic associations

AU - Jerschow, Elina

AU - Lin, Robert Y.

AU - Scaperotti, Moira M.

AU - McGinn, Aileen P.

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N2 - Results There were a total of 2458 anaphylaxis-related deaths in the United States from 1999 to 2010. Medications were the most common cause (58.8%), followed by "unspecified" (19.3%), venom (15.2%), and food (6.7%). There was a significant increase in fatal drug-induced anaphylaxis over 12 years: from 0.27 (95% CI, 0.23-0.30) per million in 1999 to 2001 to 0.51 (95% CI, 0.47-0.56) per million in 2008 to 2010 (P <.001). Fatal anaphylaxis caused by medications, food, and unspecified allergens was significantly associated with African American race and older age (P <.001). Fatal anaphylaxis to venom was significantly associated with white race, older age, and male sex (P <.001). The rates of fatal anaphylaxis to foods in male African American subjects increased from 0.06 (95% CI, 0.01-0.17) per million in 1999 to 2001 to 0.21 (95% CI, 0.11-0.37) per million in 2008 to 2010 (P <.001). The rates of unspecified fatal anaphylaxis decreased over time from 0.30 (95% CI, 0.26-0.34) per million in 1999 to 2001 to 0.09 (95% CI, 0.07-0.11) per million in 2008 to 2010 (P <.001).Conclusion There are strong and disparate associations between race and specific classes of anaphylaxis-related mortality in the United States. The increase in medication-related deaths caused by anaphylaxis likely relates to increased medication and radiocontrast use, enhanced diagnosis, and coding changes.MethodsAnaphylaxis-related deaths were identified by using the 10th clinical modification of the International Classification of Diseases system diagnostic codes on death certificates from the US National Mortality Database. Rates were calculated by using census population estimates.Background Anaphylaxis-related deaths in the United States have not been well characterized in recent years. Objectives We sought to define epidemiologic features and time trends of fatal anaphylaxis in the United States from 1999 to 2010.

AB - Results There were a total of 2458 anaphylaxis-related deaths in the United States from 1999 to 2010. Medications were the most common cause (58.8%), followed by "unspecified" (19.3%), venom (15.2%), and food (6.7%). There was a significant increase in fatal drug-induced anaphylaxis over 12 years: from 0.27 (95% CI, 0.23-0.30) per million in 1999 to 2001 to 0.51 (95% CI, 0.47-0.56) per million in 2008 to 2010 (P <.001). Fatal anaphylaxis caused by medications, food, and unspecified allergens was significantly associated with African American race and older age (P <.001). Fatal anaphylaxis to venom was significantly associated with white race, older age, and male sex (P <.001). The rates of fatal anaphylaxis to foods in male African American subjects increased from 0.06 (95% CI, 0.01-0.17) per million in 1999 to 2001 to 0.21 (95% CI, 0.11-0.37) per million in 2008 to 2010 (P <.001). The rates of unspecified fatal anaphylaxis decreased over time from 0.30 (95% CI, 0.26-0.34) per million in 1999 to 2001 to 0.09 (95% CI, 0.07-0.11) per million in 2008 to 2010 (P <.001).Conclusion There are strong and disparate associations between race and specific classes of anaphylaxis-related mortality in the United States. The increase in medication-related deaths caused by anaphylaxis likely relates to increased medication and radiocontrast use, enhanced diagnosis, and coding changes.MethodsAnaphylaxis-related deaths were identified by using the 10th clinical modification of the International Classification of Diseases system diagnostic codes on death certificates from the US National Mortality Database. Rates were calculated by using census population estimates.Background Anaphylaxis-related deaths in the United States have not been well characterized in recent years. Objectives We sought to define epidemiologic features and time trends of fatal anaphylaxis in the United States from 1999 to 2010.

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