Anaphylaxis-related deaths have not been well characterized in the US for recent years. We thus sought to analyze features of fatal anaphylaxis in the US from 1999 to 2010.
Using the US Multiple Cause of Death Data and Census data/estimates, mortality rates per 100 million (108) population were calculated for 1999-2010. Negative binomial regression models were used to assess the predictor effects of age, sex, race (African American (AA), White, Hispanics and others), and region on anaphylactic deaths.
Among specified anaphylaxis causes, medications were the most common cause of fatal anaphylaxis in the US, followed by venom and food. The most frequently specified culprit in drug anaphylaxis (DA) was antibiotics, followed by radiocontrast. Overall mortality rates from DA nearly doubled: 33.2/108 (1999-2001) to 61.1/108 (2008-2010). AA race, age>=20 and more recent year were predictors of DA mortality (p<0.001). Venom anaphylaxis (VA) deaths were most common in white adult men (30.6/108 population). White race, Age>=20, male gender and southern region were all predictors of VA mortality (p<0.001). Food anaphylaxis (FA) deaths were most common in AA men (11.3/108 population). AA race was a better predictor (p<0.001) of FA deaths than was male gender (p<0.01).
There are strong and disparate associations between race and anaphylaxis mortality due to specific allergens. The striking increase in DA deaths may relate in part to enhanced diagnosis and/ or to increased administration of medications and radiocontrast.