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Anaphylaxis-related healthcare visits increasing among US older adults

Published online: July 1, 2021

Anaphylaxis is a severe potentially life-threatening acute allergic reaction. While healthcare visits for acute allergic reactions (including anaphylaxis) appear to be increasing among children, little is known about these nationwide trends among US older adults (age ≥65 years). Older adults are a rapidly growing segment of the U.S. population, with approximately 46 million persons. Older adults are a particularly vulnerable population with unique exposures and comorbidities, which may lead to poor health outcomes with anaphylaxis.

Dr. Arroyo and colleagues at Massachusetts General Hospital investigated trends in emergency department (ED) visits and hospitalizations among US older adults presenting with acute allergic reactions (including anaphylaxis) from 2006 to 2014. The study, published in The Journal of Allergy and Clinical Immunology: In Practice, was performed by analyzing data from the Nationwide Emergency Department Sample and the National (Nationwide) Inpatient Sample, Healthcare Cost and Utilization Project (HCUP), maintained by the Agency for Healthcare Research and Quality. Acute allergic reactions and anaphylaxis, including triggers, were identified using diagnostic codes. Statistical modeling was performed to identify factors associated with severe anaphylaxis including death.

Among older adults presenting with allergic reactions, the rate of ED visits and hospitalizations remained stable overall over the study period. However, among older adults presenting with anaphylaxis, the rate of emergency department visits significantly increased from 37 to 51 visits per 100,000 population, and the hospitalization rate significantly increased from 13 to 23 hospitalizations per 100,000 population over the study period. In particular, the hospitalization rate for drug-related anaphylaxis among older adults significantly increased from 47 to 85 hospitalizations per 100,000 population over the study period. The hospitalization rate for anaphylaxis among older adults was more than double the rate for younger adults (18-64 years) across all years. Risk factors for anaphylaxis-related death included older age, especially ≥85 years of age, and drug-related trigger. Anaphylaxis, especially drug-related anaphylaxis, is a growing risk for the US older adult population.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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