Incidence and trends of anaphylaxis among inpatients from 2003 to 2023 in Wuhan, China: A multicenter retrospective study

IF 3.9 2区医学 Q2 ALLERGY World Allergy Organization Journal Pub Date : 2024-11-01 DOI:10.1016/j.waojou.2024.100980

Le Li MD , Nan Huang MD , Wenjing Li MD , Yaqi Yang MD , Dongxia Ma MD , Hao Chen MD, PhD , Rongfei Zhu MD, PhD

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Abstract

Background

The incidence of a disease can help health professionals to identify risk factors and health-care policymakers to develop corresponding policies. The realization of both purposes depends on comprehensive studies, especially studies done on a large scale. However, comprehensive studies on the incidence of anaphylaxis among inpatients in China are still notably scarce. Hence we aim to explore the incidence and clinical characteristics of anaphylaxis among inpatients over a span of 21 years in Wuhan, China.

Methods

We retrieved data on anaphylaxis cases from the Data Platform Application Portal (DPAP) across 3 medical centers of Tongji Hospital, Wuhan, China from January 1, 2003, to December 31, 2023.

Results

The data encompassed a total of 362 anaphylaxis patients from 2,139,272 inpatients. Among them 204 (56.4%) were male, and the median age was 45 years old. Over the past 2 decades, the incidence rate of anaphylaxis at Tongji Hospital was 16.92 per 100,000 individuals. After adjusting for gender and age, the annual standardized incidence rate was 234.53 per 100,000 individuals. The incidence rate of anaphylaxis among the inpatients revealed a relatively stable but slowly rising trend over the 21-year observation period. As for the triggers of anaphylaxis, drugs were responsible for 73.6% of triggers, with antibiotics representing the highest proportion of these cases (38.4%). Drug triggers also showed age-specific features: chemotherapy (17.9%) had the highest proportions among children aged 0–3 years; blood products were more prevalent in school-age children. 13.5% of the cases had an unknown cause. In anaphylaxis cases, despite that only 36.0% received epinephrine treatment, the application of epinephrine still showed an ascending trend. Moreover, the mortality rate for anaphylaxis was relatively low (1.6%), displaying a consistent downward trend.

Conclusion

Our study provides insights into the incidence of anaphylaxis among inpatients in Wuhan over a 21-year period. Drugs are the most common triggers for anaphylaxis, and the use of epinephrine in anaphylaxis management is far from optimal.

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2003-2023年中国武汉市住院患者过敏性休克的发病率及趋势：多中心回顾性研究

背景一种疾病的发病率可以帮助卫生专业人员确定风险因素，也可以帮助卫生保健政策制定者制定相应的政策。这两个目的的实现都有赖于全面的研究，尤其是大规模的研究。然而，关于中国住院病人过敏性休克发病率的全面研究仍明显不足。方法我们从武汉同济医院的数据平台应用门户（DPAP）中检索了2003年1月1日至2023年12月31日期间武汉同济医院3个医疗中心的过敏性休克病例数据。其中男性 204 人（56.4%），年龄中位数为 45 岁。在过去 20 年中，同济医院过敏性休克的发病率为每 10 万人 16.92 例。调整性别和年龄后，年标准化发病率为每 10 万人 234.53 例。在 21 年的观察期内，住院患者的过敏性休克发病率呈相对稳定但缓慢上升的趋势。至于过敏性休克的诱发因素，73.6%的诱发因素是药物，其中抗生素所占比例最高（38.4%）。药物诱因还呈现出年龄特征：化疗（17.9%）在 0-3 岁儿童中比例最高；血液制品在学龄儿童中更为普遍。13.5%的病例病因不明。在过敏性休克病例中，尽管只有 36.0% 接受了肾上腺素治疗，但肾上腺素的使用率仍呈上升趋势。此外，过敏性休克的死亡率相对较低（1.6%），呈持续下降趋势。药物是过敏性休克最常见的诱因，而肾上腺素在过敏性休克治疗中的使用远未达到最佳状态。

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来源期刊

World Allergy Organization Journal Immunology and Microbiology-Immunology

CiteScore

9.10

自引率

5.90%

发文量

审稿时长

9 weeks

期刊介绍： The official pubication of the World Allergy Organization, the World Allergy Organization Journal (WAOjournal) publishes original mechanistic, translational, and clinical research on the topics of allergy, asthma, anaphylaxis, and clincial immunology, as well as reviews, guidelines, and position papers that contribute to the improvement of patient care. WAOjournal publishes research on the growth of allergy prevalence within the scope of single countries, country comparisons, and practical global issues and regulations, or threats to the allergy specialty. The Journal invites the submissions of all authors interested in publishing on current global problems in allergy, asthma, anaphylaxis, and immunology. Of particular interest are the immunological consequences of climate change and the subsequent systematic transformations in food habits and their consequences for the allergy/immunology discipline.