Fatal and Near-Fatal Anaphylaxis: Data From the European Anaphylaxis Registry and National Health Statistics

Höfer V, Dölle-Bierke S, Francuzik W, Ruëff F, Sabouraud-Leclerc D, Treudler R, Moeser A, Hartmann K, Pföhler C, Wagner N, Ensina LF, Wedi B, Cardona V, Worm M (2024)

Publication Type: Journal article

Publication year: 2024

Journal

The Journal of Allergy and Clinical Immunology: In Practice Elsevier

Book Volume: 12

Pages Range: 96-105.e8

Journal Issue: 1

DOI: 10.1016/j.jaip.2023.09.044

Abstract

Background: Anaphylaxis is a serious systemic reaction—data on fatal and near-fatal reactions are limited. Objective: To better understand clinical patterns and risks factors of severe anaphylaxis by a deep analysis of data from fatal and near-fatal anaphylaxis. Methods: Data from the European Anaphylaxis Registry on fatal/near-fatal anaphylactic reactions and national data on anaphylaxis fatalities were investigated. Results: A total of 305 fatal/near-fatal reactions among children and adults including 35 fatalities from the European Anaphylaxis Registry were identified. The most frequent elicitors were drugs, insects, and food. Male patients (66%/60%) were more frequently affected. Male sex, higher age, concomitant mastocytosis, and cardiovascular disease were associated with a more severe outcome. With increasing reaction severity, skin symptoms were less frequently observed (45% of fatal reactions). In parallel, anaphylaxis mortality rates were studied. The data show that anaphylaxis mortality rates increased in Germany from 0.48 (2009) to 0.59 per 1,000,000 population per year (2020). This increase was apparent only in the female population. In this data set, drugs were the most frequent elicitor of anaphylaxis fatalities, and the rate for this increased over time. Conclusions: We identified not only elicitors but also individual factors to be associated with an increased risk of fatal anaphylaxis. Such patients should be recognized and managed with great caution. The increase in drug-induced fatalities points to the need for a better allergological care of patients suffering from drug hypersensitivity.

Additional Organisation(s)

FAU Profilzentrum Licht.Materie.Quantentechnologien (FAU LMQ)

Involved external institutions

Universität Leipzig DE Germany (DE) Berliner Institut für Gesundheitsforschung (BIH) DE Germany (DE) Klinikum der Universität München DE Germany (DE) Allergy Vigilance Network / Réseau d'Allergo-Vigilance FR France (FR) Universitätsklinikum Jena DE Germany (DE) Universitätsspital Basel CH Switzerland (CH) Universitätsklinikum des Saarlandes (UKS) DE Germany (DE) Federal University of São Paulo / Universidade Federal de São Paulo (UNIFESP) BR Brazil (BR) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Vall d'Hebron University Hospital / Hospital Universitari Vall d'Hebron ES Spain (ES)

How to cite

APA:

Höfer, V., Dölle-Bierke, S., Francuzik, W., Ruëff, F., Sabouraud-Leclerc, D., Treudler, R.,... Worm, M. (2024). Fatal and Near-Fatal Anaphylaxis: Data From the European Anaphylaxis Registry and National Health Statistics. The Journal of Allergy and Clinical Immunology: In Practice, 12(1), 96-105.e8. https://dx.doi.org/10.1016/j.jaip.2023.09.044

MLA:

Höfer, Veronika, et al. "Fatal and Near-Fatal Anaphylaxis: Data From the European Anaphylaxis Registry and National Health Statistics." The Journal of Allergy and Clinical Immunology: In Practice 12.1 (2024): 96-105.e8.

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