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Medications most frequently caused fatal anaphylaxis in US

Medications were the most frequent cause of anaphylaxis-related deaths in the US between 1999 and 2010, with race and age determining factors, according to recent study results.

“Anaphylaxis-related deaths in the US have not been well understood in recent years,” Elina Jerschow, MD, MSc, director, Drug Allergy Center, Montefiore Medical Center, and assistant professor of medicine, Albert Einstein College, said in a press release. “We hope these findings will help in identifying specific risk factors and allow physicians to formulate preventive approaches.”

Elina Jerschow

Jerschow and colleagues analyzed the National Mortality Database by using ICD-10 codes on death certificates to identify 2,458 anaphylaxis-related deaths between 1999 and 2010. Census data were used to calculate rates.

Almost 59% of anaphylaxis-related deaths were associated with medications, followed by “unspecified” (19.3%), venom (15.2%) and food (6.7%). Fatal drug-induced anaphylaxis increased significantly from 0.27 (95% CI, 0.23-0.3) per million in 1999-2001 to 0.51 (95% CI, 0.47-0.56) per million in 2008-2010.

Researchers said an association existed between black race and older age in fatal anaphylaxis caused by medications, food and unspecified allergens (P<.001). White race, older age and male sex were associated with fatal anaphylaxis to venom (P<.001). Among black men, the rate of fatal anaphylaxis to foods increased from 0.06 (95% CI, 0.01-0.17) per million in 1999-2001 to 0.21 (95% CI, 0.11-0.37) per million in 2008-2010.

Rates of unspecified fatal anaphylaxis declined.

“The increase in medication-related deaths caused by anaphylaxis likely relates to increased medication and radiocontrast use, enhanced diagnosis and coding changes,” the researchers concluded.

“Anaphylaxis has been dubbed ‘the latest allergy epidemic,’ ” Jerschow said. “The US and Australia have some of the highest rates of severe anaphylaxis among developed countries. We hope these results bring increased awareness of the need for a better understanding of anaphylaxis deaths.”

Disclosure: The researchers report no relevant financial disclosures.