A population-based epidemiological study of anaphylaxis using national big data in Korea: trends in age-specific prevalence and epinephrine use in 2010–2014

Abstract

BackgroundPrevious reports on anaphylaxis in Asia are limited to relatively small-scale studies. We performed this study to identify the nationwide prevalence of anaphylaxis and epinephrine prescription rates by age groups.MethodsThe total number of patients, yearly and overall prevalence, percentage of emergency department visits, and epinephrine prescription rates were calculated for patients diagnosed with anaphylaxis based on the Korean National Health Insurance database from 2010 to 2014.ResultsThe mean prevalence of anaphylaxis in Korea was 26.23 (95% confidence interval, CI 25.78–26.68) per 100,000 person-years during the 5 years. It increased from 20.55 (95% CI 20.15–20.10) in 2010 to 35.33 (95% CI 34.81–35.85) per 100,000 person-years in 2014. The average prevalence was > 35 per 100,000 person-years among 50–69 year-olds, and the mean crude prevalence in children was 22.3 (0–2 years), 17.3 (3–6 years), 12.1 (7–12 years), and 14.9 (13–17 years) per 100,000 person-years, respectively. The overall prevalence increased 1.7-fold, with the highest rate of increase in 0–2 years of age. The overall percentage of emergent anaphylaxis patients was 88.4%, and the prevalence of emergent anaphylaxis increased from 18.63 (95% CI 18.25–19.01) to 31.28 (95% CI 30.79–31.77) per 100,000 person-years. In-hospital epinephrine prescription rate increased from 31.5 to 39.7%.ConclusionsThe mean prevalence of anaphylaxis in Korea was 26.2 per 100,000 person-years during the study period. The total number of anaphylaxis patients increased 1.7-fold from 2010 to 2014, with the most noticeable increment being in young children.

Anaphylaxis – Lessons learnt when East meets West

“…A recent population-based study from Korea also documented a 1.9-fold increase in the prevalence of anaphylaxis. 52 These Asian data suggest at least a 2-fold rise in anaphylaxis incidence rate in the past 20 years, which is similar to the reported data from the West. A 1.89-fold (89%) increase in the incidence of hospital admissions for anaphylaxis, from 1.35 to 2.38 per 100 000 person-years, between 1998 and 2011 in Spain, was reported, 53 for which the greatest increase was in food-induced anaphylaxis in the 0-to 14-year age group.…”

“…The largest increase in this study was seen in the 0‐ to 9‐year‐old age group (4.1‐19.7 per 100 000 person‐years) but it was not reported whether this increase could be attributed to food anaphylaxis. A recent population‐based study from Korea also documented a 1.9‐fold increase in the prevalence of anaphylaxis . These Asian data suggest at least a 2‐fold rise in anaphylaxis incidence rate in the past 20 years, which is similar to the reported data from the West.…”

“…Studies with data on anaphylaxis treatment modalities and the prevalence of biphasic anaphylaxis among the studies with available data are summarized in Table S2 3,6,8,10,12,13,23,24,31,33,36,39,41,54 and Table S3, 3,6,8,10,12,13,23,30,31,33,52,55,56 respectively. Few studies were able to identify predictors of biphasic anaphylaxis.…”

Common causes of emergency department visits for anaphylaxis in Korean community hospitals

“…[15,21] Present study also showed the increase of ED visits for anaphylaxis in Korea, which is consistent with previous reports that prevalence rates of anaphylaxis have increased in recent years worldwide, [3,22–25] and in Korea. [26,27] Although it may need more studies to understand the reason why incidence of anaphylaxis increase, changes in environments and lifestyle, and increase of awareness about anaphylaxis might be one of the reasons for increase ED visits for anaphylaxis.…”

A multicenter anaphylaxis registry in Korea: Clinical characteristics and acute treatment details from infants to older adults

“…In Korea, previous anaphylaxis studies were mostly retrospective medical chart reviews focusing on specific age groups, either children or adults. 12 , 13 Recent big data analyses on anaphylaxis are useful in investigating the epidemiology or trends over a period of time; 14 , 15 however, limitations exist as some factors such as eliciting triggers, severity, or treatment cannot be identified through the national big data. Hence, we developed a multicenter web-based registry to investigate the triggers, clinical features, and treatment details of anaphylaxis in Korean patients, including all age groups.…”