title: Incidence of anaphylaxis and subtypes of anaphylaxis in a general hospital emergency department.
abstract: BACKGROUND
  The absence of large-scale international studies means that data on anaphylaxis in emergency departments in different geographic areas are still necessary.
  
  
  OBJECTIVE
  To determine the incidence of anaphylaxis and subtypes of anaphylaxis and their distribution by age group in the emergency department of Hospital Universitario Fundación Alcorcon, Alcorcon (Madrid), Spain.
  
  
  METHODS
  Our study was performed between 2004 and 2005. We used the definition of anaphylaxis established by the NIAID-FAAN Symposium. Patient information was collected from the electronic clinical records of the emergency department using alphanumeric strings to identify acute allergic illnesses. This strategy recovered 91.7% of all anaphylaxis episodes in a pilot study.
  
  
  RESULTS
  We observed a crude cumulative incidence of 0.9 episodes of anaphylaxis per 1000 emergency episodes (95% confidence interval [CI], 0.8-1.1), and 0.8 episodes per 1000 people (95% CI, 0.7-0.9). Standardized cumulative incidence of anaphylaxis according to the Standardized European Population was 1.1 (95% CI, 0.9-1.2). On analyzing the 213 cases of anaphylaxis, we discovered that the main cause was food (28.6%), followed by drugs (28.2%), unknown causes (27.2%), Anisakis (10.8%), Hymenoptera venom (3.3%), exercise (2.4%), and latex (0.9%). Food-induced anaphylaxis was less frequent in all groups older than the 0-4 age group in both reference populations (people who attend the emergency department and the general population).
  
  
  CONCLUSIONS
  The cumulative incidence of anaphylaxis in our emergency department is low. Anaphylaxis by foods is more frequent in the 0-4 year group than in the other age groups. Drugs and food are the most frequent causes of anaphylaxis in our emergency department.
authors.affiliation: Allergy Unit, Hospital Universitario Fundacion Alcorcón, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Moro Moro
authors.forename: M A
authors.initials: MA
authors.lastname: Tejedor Alonso
authors.forename: J
authors.initials: J
authors.lastname: Esteban Hernández
authors.forename: M V
authors.initials: MV
authors.lastname: Múgica García
authors.forename: A
authors.initials: A
authors.lastname: Rosado Ingelmo
authors.forename: C
authors.initials: C
authors.lastname: Vila Albelda
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005512:Food Hypersensitivity; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D055815:Young Adult