Increasing Emergency Department Visits for Anaphylaxis, 2005-2014

J Allergy Clin Immunol Pract. Jan-Feb 2017;5(1):171-175.e3. doi: 10.1016/j.jaip.2016.08.013. Epub 2016 Nov 3.

Abstract

Background: Anaphylaxis is a potentially life-threatening systemic allergic reaction. Studies suggest that the incidence of anaphylaxis is increasing; however, recent trends in emergency department (ED) visits for anaphylaxis in the United States have not been studied.

Objective: To examine trends in the incidence and rates of anaphylaxis-related ED visits from 2005 through 2014.

Methods: We retrospectively analyzed data from a national administrative claims database including commercially insured and Medicare Advantage patients. We identified all ED visits for anaphylaxis and calculated rates as number of anaphylaxis-related ED visits per 100,000 enrollees. Rates were compared over time and by age and trigger.

Results: During the 10-year time period, 56,212 ED visits for anaphylaxis were identified. The median (interquartile range) age was 36 (17-52 years) years, and 58% were female. Most cases (57%) were due to unspecified triggers, 27% were associated with food, 12% were medication related, and 4% were due to insect venom. The overall rate of anaphylaxis per 100,000 enrollees increased by 101%, from 14.2 in 2005 to 28.6 in 2014 (P < .001). Rates of ED visits for anaphylaxis increased in all age groups, but the greatest increase was in children aged 5 to 17 years (196% increase; P < .001). The rate of food-related anaphylaxis increased by 124% (P < .001), and the rate of medication-related anaphylaxis increased by 212% (P < .001).

Conclusions: ED visits for anaphylaxis increased between 2005 and 2014. Increases in ED visits were greatest among children.

Keywords: Anaphylaxis; Emergency department; Epidemiology; Time trends.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Allergens / immunology*
  • Anaphylaxis / epidemiology*
  • Anaphylaxis / etiology
  • Child
  • Child, Preschool
  • Emergency Medical Services*
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Hypersensitivity / complications
  • Hypersensitivity / epidemiology*
  • Incidence
  • Insurance Claim Review
  • Male
  • Retrospective Studies
  • United States / epidemiology
  • Young Adult

Substances

  • Allergens