Journal article
Rate of recurrent anaphylaxis and associated risk factors among Olmsted County, Minnesota, residents
Annals of allergy, asthma, & immunology, Vol.117(6), pp.655-660.e2
12/01/2016
DOI: 10.1016/j.anai.2016.09.444
PMCID: PMC5172382
PMID: 27979023
Abstract
Background: The rate and risk factors for recurrence of anaphylaxis are not well known.
Objective: To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota.
Methods: We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010. We evaluated the rate and associations of risk factors with anaphylaxis recurrence.
Results: Among the 611 patients with anaphylaxis, 50 (8%) experienced a total of 60 recurrences within the 10-year period, resulting in a recurrence rate of 2.6 per 100 person-years. A history of atopic dermatitis (hazard ratio [HR], 5.6; 95% confidence interval [CI], 2.0-16.1; P < .001), presenting symptoms of cough (HR, 4.7; 95% CI, 2.1-10.7; P < .001) oral pruritus (HR, 9.9; 95% CI, 4.3-23.2; P < .001), and receiving corticosteroids (HR, 5.2; 95% CI, 2.3-11.7; P < .001) were associated with an increased risk of recurrence. The cardiovascular symptom of chest pain (HR, 0.24; 95% CI, 0.07-0.79; P = .02) was associated with a decreased risk of recurrence.
Conclusion: In this epidemiologic study, the rate of recurrence was 8% during the 10-year study period (recurrence rate of 2.6 per 100 person-years). Those with atopic dermatitis and mucocutaneous or respiratory symptoms were more likely to have a recurrent anaphylactic event. Our findings underscore the importance of early patient access to self-injectable epinephrine and referral to an allergist/ immunologist for additional testing and education. (C) 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Rate of recurrent anaphylaxis and associated risk factors among Olmsted County, Minnesota, residents
- Creators
- Sangil Lee - Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaCurtis Bashore - Mayo ClinicChristine M. Lohse - Mayo Clinic in FloridaM. Fernanda Bellolio - Mayo ClinicAlanna Chamberlain - Mayo Clinic in FloridaKumi Yuki - The REACH Institute, New York, New YorkErik P. Hess - Mayo ClinicRonna L. Campbell - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Annals of allergy, asthma, & immunology, Vol.117(6), pp.655-660.e2
- DOI
- 10.1016/j.anai.2016.09.444
- PMID
- 27979023
- PMCID
- PMC5172382
- NLM abbreviation
- Ann Allergy Asthma Immunol
- ISSN
- 1081-1206
- eISSN
- 1534-4436
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- UL1TR000135 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) R01AG034676 / NATIONAL INSTITUTE ON AGING; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) R01AG034676 / National Institute on Aging of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) UL1 TR000135 / Clinical and Translational Science Award from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health
- Language
- English
- Date published
- 12/01/2016
- Academic Unit
- Psychiatry; Emergency Medicine; Family and Community Medicine; Injury Prevention Research Center
- Record Identifier
- 9984296969602771
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