Elina Jerschow, MD, MSc, Robert Y. Lin, MD, MSc, Moira M

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Presentation transcript:

Fatal anaphylaxis in the United States, 1999-2010: Temporal patterns and demographic associations Elina Jerschow, MD, MSc, Robert Y. Lin, MD, MSc, Moira M. Scaperotti, BS, Aileen P. McGinn, PhD Journal of Allergy and Clinical Immunology Volume 134, Issue 6, Pages 1318-1328.e7 (December 2014) DOI: 10.1016/j.jaci.2014.08.018 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Fatal drug-induced anaphylaxis features. A, Rates by age groups, all races, and sexes combined. Drug-induced anaphylaxis was significantly associated with age (P < .001). B, Rates by race and age groups, both sexes. Drug-induced anaphylaxis was significantly associated with African American race (P < .001). C, Rates over time by race and sex. Fatal anaphylaxis to drugs significantly increased over 12 years among all races and both sexes (P < .001). No significant difference was observed between female and male subjects. D, Culprit medications in fatal drug-induced anaphylaxis with specified medications (n = 368). E, Culprit medications in fatal algorithm-identified anaphylaxis with specified medications (n = 148). Error bars show 95% CIs. Journal of Allergy and Clinical Immunology 2014 134, 1318-1328.e7DOI: (10.1016/j.jaci.2014.08.018) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Fatal anaphylaxis by geographic region performed as a subset analysis, 1999-2004. A, Drug-induced anaphylaxis rates were lower in the Northeast census region (P < .001). B, Venom-induced anaphylaxis rates were higher in the South census region (P < .001). C, There was no significant association with geographic region for food-induced anaphylaxis. D, The West census region had lower unspecified anaphylaxis rates (P = .03). Maps were created with an interactive map tool available at http://diymaps.net. Journal of Allergy and Clinical Immunology 2014 134, 1318-1328.e7DOI: (10.1016/j.jaci.2014.08.018) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Fatal venom-induced anaphylaxis features. A, Rates by age groups, all races and sexes combined. Venom-induced anaphylaxis was significantly associated with age (P < .001). B, Rates by race and age groups, both sexes. Venom-induced anaphylaxis was significantly associated with white race (P < .001). C, Rates over time by race and sex. Venom-induced anaphylaxis was significantly associated with male sex (P < .001). There was no significant increase over time in fatal anaphylaxis to venom. Error bars show 95% CIs. Journal of Allergy and Clinical Immunology 2014 134, 1318-1328.e7DOI: (10.1016/j.jaci.2014.08.018) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Fatal food-induced anaphylaxis features. A, Rates by age groups, all races and sexes combined. Fatal food-induced anaphylaxis was significantly associated with age (P = .02). B, Rates by race and age groups, both sexes. Food-induced anaphylaxis was significantly associated with African American race (P < .001). C, Rates over time by race and sex. There was a significant increase over time in fatal anaphylaxis to food among African American male subjects (P < .001). Error bars show 95% CIs. Journal of Allergy and Clinical Immunology 2014 134, 1318-1328.e7DOI: (10.1016/j.jaci.2014.08.018) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Unspecified fatal anaphylaxis features. A, Rates by age groups, all races and sexes combined. Unspecified fatal anaphylaxis was significantly associated with age (P < .001). B, Rates by race and age groups, both sexes. Unspecified anaphylaxis was significantly associated with African American race (P < .001). C, Rates over time by race and sex. There was a significant decrease over time in unspecified fatal anaphylaxis among all races and both sexes (P < .001). Journal of Allergy and Clinical Immunology 2014 134, 1318-1328.e7DOI: (10.1016/j.jaci.2014.08.018) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Analysis of the time trend on combined drug-induced and unspecified fatal anaphylaxis cases. Error bars show 95% CIs. Journal of Allergy and Clinical Immunology 2014 134, 1318-1328.e7DOI: (10.1016/j.jaci.2014.08.018) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions