A study published in the journal BMJ describes the death rate from food-induced anaphylaxis that has halved despite the greatly increased hospital admission rates in the UK due to this life-threatening allergic reaction disease.
Food allergies are the most common cause of a potentially life-threatening allergic reaction, known as anaphylaxis. Substantial increases in hospital admissions due to food anaphylaxis have been reported globally, but it is unclear whether this trend continues, and if so, whether it has led to an increase in fatal reactions.
To explore this further, researchers from Imperial College London’s National Heart & Lung Institute began describing trends in hospital admission times for food anaphylaxis in the UK over the past 20 years.
They studied data between 1998 and 2018, measured trends in time, age, and sex distribution for anaphylactic admissions due to food and non-food triggers, and then compared them to reported deaths.
Between 1998 and 2018, 101,891 people were hospitalized for anaphylaxis. Of these, 30,700 (30%) were coded for food triggers.
Acceptance of food anaphylaxis increased from 1.23 to 4.04 per 100,000 population per year (from 1998 to 2018), an annual increase of 5.7%.
The largest increase in hospital admissions was seen for children under 15 years, with an increase from 2.1 to 9.2 admissions per 100,000 population per year (an annual increase of 6.6%, compared to 5.9% for people aged 15-59 years and 2.1% in those aged 60 years and over).
Over a 20 year period, 152 deaths were identified in which the fatal event may have been due to food-induced anaphylaxis.
The case-fatality rate (number of deaths as a proportion of admissions) decreased from 0.7% to 0.19% for confirmed fatal food anaphylaxis and to 0.3% for food anaphylaxis that was suspected to be fatal.
At least 86 (46%) of all deaths between 1992-2018 were triggered by peanuts or tree nuts, while cow’s milk was responsible for 17 (26%) deaths in school-age children.
The data also show that over the same time period, prescriptions for adrenaline autoinjectors increased 336% – an increase of 11% per year.
The investigators say that improvements in the introduction and management of anaphylaxis may partially explain the reduction in case mortality despite increasing hospital admissions for anaphylaxis.
There is no evidence to suggest that the clinical criteria used to diagnose anaphylaxis have changed in the UK over the study period, they added. Although the National Institute for Health and Care Excellence (NICE) introduced national guidelines in 2011, which could result in an increase in the number of hospitalized patients, year-on-year increases have continued since then.
The authors acknowledged some of the study limitations, such as the possibility of some miscoded or misdiagnosed anaphylaxis cases, and they were unable to include anaphylaxis cases seen in an emergency department that did not require hospital admission.
However, they do use national data sets in the context of the UK health system, which provides an opportunity to draw strong conclusions compared to other countries.
Thus, the researchers conclude: “Cow’s milk is increasingly being identified as an allergen cause for fatal food reactions, and is now the most common cause of fatal anaphylaxis in children. More education is needed to highlight the specific risks that cow’s milk poses to people. -people who are allergic to raise awareness among the food business. “
They added: “Further work is needed to assess evidence of age-related susceptibility to severe anaphylaxis in young adults, thereby increasing our ability to stratify the risk of patients with food allergies and to reduce the risk of fatal outcomes.”
This story has been published from wire agent bait without modification to the text.