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Anaphylaxis Fatalities in Australia 1997 to 2013
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Raymond James Mullins, FRACP FRCPA PhD FAAAAI, Woei Kang Liew, MD, Brynn Wainstein, FRACP, PhD, Elizabeth H Barnes, BAppSc, MStat, Dianne E. Campbell, MD, FRACP, PhD
Rationale:

The objective of this study was to determine whether Australian fatal anaphylaxis (FA) rates have increased in line with increases in hospital anaphylaxis admission rates.

Methods:

Australian FA and hospital anaphylaxis admission rates were examined, using data derived from the Australian Institute of Health and Welfare and the Australian Bureau of Statistics over the period 1997-2013. Time trends were analyzed using Poisson regression with year (1997 to 2013) as a continuous predictor and total population as exposure variable.

Results:

323 cases of FA were reported in Australia between 1997 and 2013. Fatalities were attributed to; medication (52 cases), insect stings/tick bites (21 cases), food (23 cases), serum (3 cases) or unspecified cause (224 cases).  Overall FA rates increased 1.8 fold from 0.05 (1997) to 0.09/100,000 (2013). FA increased 6.2% per year (95% CI: 3.8 to 8.6%, P<0.0001) and food-related FA increased 9.7% per year (95% CI: 0.25 to 20%, P=0.044). Total hospital anaphylaxis admissions (HAA) increased 3.9 fold, from 5.0 to 19.2/ 100,000 and food anaphylaxis admissions increased from 2.1 to 8.9 (4.2-fold) over the same period. HAA increased by 8.0% per year (95% CI: 7.8 to 8.3%, P<0.0001) and by 10.0% per year for food anaphylaxis admissions (95% CI: 9.9 to 10.6%, P<0.0001).

Conclusions:

We report preliminary evidence of a rise in Australian FA (and food-related FA) rates comparable with increases in hospital admission rates. Our data contrast with recent UK and USA-based studies describing lower overall FA rates (0.047- 0.069/100,000) and rising hospital anaphylaxis admission rates without a rise in fatalities.