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Increases in anaphylaxis fatalities in Australia from 1997 to 2013

Mullins, R J; Wainstein, B K; Barnes, E H; Liew, W K; Campbell, D E

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BACKGROUND Recent epidemiological studies indicate increases in Australian, UK and US hospital anaphylaxis admission rates. OBJECTIVES The aim of this study was to determine whether Australian anaphylaxis fatalities are increasing in parallel and to examine the characteristics of fatalities recorded in the National Coronial Information System (NCIS). METHODS Time trends in Australian anaphylaxis fatalities were examined using data derived from the Australian Bureau of Statistics (ABS) 1997-2013...[Show more]

dc.contributor.authorMullins, R J
dc.contributor.authorWainstein, B K
dc.contributor.authorBarnes, E H
dc.contributor.authorLiew, W K
dc.contributor.authorCampbell, D E
dc.date.accessioned2016-09-15T05:45:33Z
dc.date.available2016-09-15T05:45:33Z
dc.identifier.issn0954-7894
dc.identifier.urihttp://hdl.handle.net/1885/108888
dc.description.abstractBACKGROUND Recent epidemiological studies indicate increases in Australian, UK and US hospital anaphylaxis admission rates. OBJECTIVES The aim of this study was to determine whether Australian anaphylaxis fatalities are increasing in parallel and to examine the characteristics of fatalities recorded in the National Coronial Information System (NCIS). METHODS Time trends in Australian anaphylaxis fatalities were examined using data derived from the Australian Bureau of Statistics (ABS) 1997-2013 and the NCIS 2000-2013, the latter providing additional information to verify cause and identify risk factors. RESULTS The ABS recorded 324 anaphylaxis fatalities by cause: unspecified (n = 205); medication (n = 52); insect stings/tick bites (n = 41); food (n = 23); and blood products (n = 3). From 1997 to 2013, all-cause fatal anaphylaxis rates increased by 6.2%/year (95% CI: 3.8-8.6%, P < 0.0001) or from 0.054% to 0.099/10(5) population. Fatal food anaphylaxis increased by 9.7%/year (95% CI: 0.25-20%, P = 0.04) and unspecified anaphylaxis deaths by 7.8% (95% CI: 4.6-11.0, P < 0.0001). There was an insignificant change in medication-related fatalities (5.6% increase/year; 95% CI: 0.3% decrease to 11.8% increase, P = 0.06), and sting/bite fatalities remained unchanged. Hospital anaphylaxis admission rates for all-cause, food, unspecified and medication anaphylaxis increased at rates of 8%, 10%, 4.4% and 6.8%/year, respectively. A total of 147 verified NCIS deaths were examined in detail: medication- and sting/bite-related fatalities occurred predominantly in older individuals with multiple comorbidities. Upright posture after anaphylaxis was associated with risk of sudden death (all causes). Seafood (not nuts) was the most common trigger for food-related anaphylaxis deaths. CONCLUSIONS Australian anaphylaxis fatality rates (most causes) have increased over the last 16 years, contrasting with UK- and US-based studies that describe overall lower and static overall anaphylaxis fatality rates (0.047-0.069/10(5) population).
dc.description.sponsorshipFunding for fees charged by the ABS and NCIS for dataaccess was provided by the Australasian Society forClinical Immunology and Allergy (ASCIA).
dc.publisherWiley
dc.rights© 2016 John Wiley & Sons Ltd
dc.sourceClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
dc.subjectanaphylaxis
dc.subjectepidemiology
dc.subjectfatal anaphylaxis
dc.subjectfood allergy
dc.titleIncreases in anaphylaxis fatalities in Australia from 1997 to 2013
dc.typeJournal article
local.identifier.citationvolume46
dc.date.issued2016-08
local.publisher.urlhttp://au.wiley.com/WileyCDA/
local.type.statusPublished Version
local.contributor.affiliationMullins, R. J., Medical School, The Australian National University
local.identifier.essn1365-2222
local.bibliographicCitation.issue8
local.bibliographicCitation.startpage1099
local.bibliographicCitation.lastpage1110
local.identifier.doi10.1111/cea.12748
CollectionsANU Research Publications

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