Anaphylaxis: hospital admission has increased.

Clinical bottom line (level 2c)

  1. Admission to hospital for anaphylaxis, in England, has increased each year since 1995.
  2. Reaction to both food and medicinal substances has increased.
Wilson : British Medical Journal 2000; 321: 1021-1022
Expires February 2003

The study

Outcome study with ?objective ?blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: nationwide, England

0 patients (aged ?, ?% male) admitted with anaphylaxis



Outcomes studied:
  • anaphylaxis 1995-6
  • anaphylaxis 1996-7
  • anaphylaxis 1997-8
  • anaphylaxis 1998-9
  • due to food, 1995-6
  • due to medicinal substance, 1995-6
  • due to food, 1996-7
  • due to medicinal substance, 1996-7
  • due to food, 1997-8
  • due to medicinal substances, 1997-8
  • due to food, 1998-9
  • due to medicinal substances, 1998-9

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    anaphylaxis 1995-6 ? 501/ .%
    (% to %)
    anaphylaxis 1996-7 ? 840/ %
    (% to %)
    anaphylaxis 1997-8 ? 1096/ %
    (% to %)
    anaphylaxis 1998-9 ? 1202/ %
    (% to %)
    due to food, 1995-6 ? 158/501 31.5%
    (27.5% to 35.6%)
    due to medicinal substance, 1995-6 ? 113/501 22.6%
    (18.9% to 26.2%)
    due to food, 1996-7 ? 312/840 37.1%
    (33.9% to 40.4%)
    due to medicinal substance, 1996-7 ? 153/840 18.2%
    (15.6% to 20.8%)
    due to food, 1997-8 ? 390/1096 35.6%
    (32.7% to 38.4%)
    due to medicinal substances, 1997-8 ? 183/1096 16.7%
    (14.5% to 18.9%)
    due to food, 1998-9 ? 406/1202 33.8%
    (31.1% to 36.5%)
    due to medicinal substances, 1998-9 ? 235/1202 19.6%
    (17.3% to 21.8%)

    • Serum was a much less common cause, and almost half of cases had an unspecified cause.

    Comments

    1. Letter about Sheikh and Alves. Hospital admissions for acute anaphylaxis: time trend study. BMJ 2000; 320: 1141.

    Citation

    1. Wilson R, : Upward trend in acute anaphylaxis continued in 1998-9. British Medical Journal 2000; 321: 1021-1022
    Contributor: Clare Wotton, February 2001
    Reviewer:

    Clinical Question.
    Patient prevalences
    Intervention or Exposure admission
    Outcome anaphylaxis