Increasing Emergency Department Visits for Anaphylaxis, 2005-2014.
Anaphylaxis is a potentially life-threatening systemic allergic reaction. Studies suggest that the incidence of anaphylaxis is increasing; however, recent trends in emergency department (ED) visits for anaphylaxis in the United States have not been studied.



To examine trends in the incidence and rates of anaphylaxis-related ED visits from 2005 through 2014.



We retrospectively analyzed data from a national administrative claims database including commercially insured and Medicare Advantage patients. We identified all ED visits for anaphylaxis and calculated rates as number of anaphylaxis-related ED visits per 100,000 enrollees. Rates were compared over time and by age and trigger.



During the 10-year time period, 56,212 ED visits for anaphylaxis were identified. The median (interquartile range) age was 36 (17-52 years) years, and 58% were female. Most cases (57%) were due to unspecified triggers, 27% were associated with food, 12% were medication related, and 4% were due to insect venom. The overall rate of anaphylaxis per 100,000 enrollees increased by 101%, from 14.2 in 2005 to 28.6 in 2014 (P < .001). Rates of ED visits for anaphylaxis increased in all age groups, but the greatest increase was in children aged 5 to 17 years (196% increase; P < .001). The rate of food-related anaphylaxis increased by 124% (P < .001), and the rate of medication-related anaphylaxis increased by 212% (P < .001).



ED visits for anaphylaxis increased between 2005 and 2014. Increases in ED visits were greatest among children.
Division of Allergic Diseases, Mayo Clinic, Rochester, Minn.
Megan S
MS
Motosue
Department of Emergency Medicine, Mayo Clinic, Rochester, Minn; Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, Minn.
M Fernanda
MF
Bellolio
Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, Minn.
Holly K
HK
Van Houten
Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, Minn; Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minn; OptumLabs, Cambridge, Mass.
Nilay D
ND
Shah
Department of Emergency Medicine, Mayo Clinic, Rochester, Minn. Electronic address: campbell.ronna@mayo.edu.
Ronna L
RL
Campbell
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000485:Allergens / Q000276:immunology*; D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000453:epidemiology*; D015994:Incidence; D007345:Insurance Claim Review; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D000485:Allergens
Anaphylaxis; Emergency department; Epidemiology; Time trends