Trends in Childhood Anaphylaxis in Singapore: 2015–2022

IF 6.3 2区医学 Q1 ALLERGY Clinical and Experimental Allergy Pub Date : 2024-06-26 DOI:10.1111/cea.14528

Si Hui Goh, Gaik Chin Yap, Hsin Yue Cheng, Wen Chin Chiang, Jian Yi Soh, Kok Wee Chong, Anne Goh, Elizabeth Huiwen Tham, Arif Tyebally, Sashikumar Ganapathy, Irwani Ibrahim, Bee Wah Lee

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Abstract

Background

There has been limited data regarding the incidence of anaphylaxis in Asia. We aim to describe patterns in patient characteristics, triggers and clinical presentation of childhood anaphylaxis in Singapore.

Methods

This was a retrospective review of emergency electronic medical records of children with anaphylaxis. Patients with the allergy-related diagnoses of anaphylaxis, angioedema, allergy and urticaria based on ICD-9 codes were screened. Cases fulfilling the World Allergy Organization criteria for anaphylaxis were included.

Results

A total of 1188 cases of anaphylaxis were identified with a median age of 6.3 years. Extrapolating data from the study sites, from 2015 to 2022, the incidence rate of childhood anaphylaxis emergency visits in Singapore doubled from 18.9 to 38.8 per 100,000 person-years, with an incidence rate ratio (IRR) of 2.06 (95% confidence interval [CI] 1.70–2.49). In 2022, the incidence rate of food anaphylaxis was 30.1 per 100,000 person-years, IRR 2.39 (95% CI 1.90–3.01) and drug anaphylaxis was 4.6 per 100,000 person-years, IRR 1.89 (95% CI 1.11–3.25). The incidence rate in children aged 0–4 years quadrupled during the study period. Common triggers were egg (10.4%), peanut (9.3%), tree nut (8.8%), milk (8%), shellfish (7.8%) and non-steroidal anti-inflammatory drug (4.4%). The majority (88.6%) of patients were treated with intramuscular adrenaline. Total number of allergy-related visits did not increase over time between 2015 and 2019. Rates of severe anaphylaxis, namely anaphylactic shock and admission to high-dependency and intensive care, did not increase over time, with a mean incidence of 1.6, IRR 0.85 (95% CI 0.40–1.83) and 0.7, IRR 1.77 (95% CI 0.54–5.76) per 100,000 person-years, respectively.

Conclusion

While the number of emergency visits due to childhood anaphylaxis has increased, the number of cases of allergy-related visits, anaphylactic shock and anaphylaxis requiring high-dependency and intensive care did not rise.

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新加坡儿童过敏性休克的趋势：2015-2022 年。

背景：有关亚洲过敏性休克发病率的数据十分有限。我们旨在描述新加坡儿童过敏性休克的患者特征、诱因和临床表现模式：这是一项对过敏性休克儿童急诊电子病历的回顾性研究。根据 ICD-9 编码，筛选出过敏性休克、血管性水肿、过敏和荨麻疹等过敏相关诊断的患者。符合世界过敏组织过敏性休克标准的病例也包括在内：结果：共发现 1188 例过敏性休克病例，中位年龄为 6.3 岁。根据研究地点的数据推断，从2015年到2022年，新加坡儿童过敏性休克急诊的发病率翻了一番，从每10万人年18.9例增加到38.8例，发病率比（IRR）为2.06（95%置信区间[CI] 1.70-2.49）。2022 年，食物过敏性休克的发病率为每 10 万人年 30.1 例，IRR 为 2.39（95% 置信区间 [CI]：1.90-3.01）；药物过敏性休克的发病率为每 10 万人年 4.6 例，IRR 为 1.89（95% 置信区间 [CI]：1.11-3.25）。在研究期间，0-4 岁儿童的发病率翻了两番。常见的诱发因素包括鸡蛋（10.4%）、花生（9.3%）、树坚果（8.8%）、牛奶（8%）、贝类（7.8%）和非甾体抗炎药（4.4%）。大多数患者（88.6%）接受了肌肉注射肾上腺素治疗。2015 年至 2019 年期间，过敏相关就诊总人数并未随时间推移而增加。严重过敏性休克（即过敏性休克和入住高依赖性护理和重症监护）的发生率并未随时间推移而增加，平均发生率分别为每10万人年1.6例（IRR为0.85（95% CI为0.40-1.83））和0.7例（IRR为1.77（95% CI为0.54-5.76））：虽然儿童过敏性休克导致的急诊就诊人数有所增加，但与过敏相关的就诊、过敏性休克以及需要高度依赖性和重症监护的过敏性休克病例数量并未增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Allergy 医学-过敏

CiteScore

10.40

自引率

9.80%

发文量

189

审稿时长

3-8 weeks

期刊介绍： Clinical & Experimental Allergy strikes an excellent balance between clinical and scientific articles and carries regular reviews and editorials written by leading authorities in their field. In response to the increasing number of quality submissions, since 1996 the journals size has increased by over 30%. Clinical & Experimental Allergy is essential reading for allergy practitioners and research scientists with an interest in allergic diseases and mechanisms. Truly international in appeal, Clinical & Experimental Allergy publishes clinical and experimental observations in disease in all fields of medicine in which allergic hypersensitivity plays a part.