Researchers from Albert Einstein College of Medicine and Weill-Cornell Medical College identified 2,458 anaphylaxis-related deaths that occurred between 1999 and 2010 from diagnostic codes on death certificates from the U.S. National Mortality Database.
The study reports that medications were identified as the trigger in 58.8 percent (1,446) of those deaths and, most likely, were the trigger in many of the 475 deaths (19.3%) caused by “unspecified” allergens, HCP Live reports. Many of the death certificates that indicated medical triggers did not name individual medications, but for those that did, antibiotics were the most common, causing 149 deaths.
The analysis revealed a significant increase in fatal drug-induced anaphylaxis over the study period
Radiocontrast agents used in diagnostic imaging tests were blamed for another 100 fatalities, while chemotherapy drugs were listed in 46 cases. Less common triggers included serum, opiates, blood pressure medications, nonsteroidal anti-inflammatory drugs (NSAIDs), and anesthetics, according to HCP Live. The study appeared in the Journal of Allergy and Clinical Immunology.
The analysis revealed a significant increase in fatal drug-induced anaphylaxis over the study period, from 0.27 (95% confidence interval [CI], 0.23-0.30) per million in 1999 to 2001 to 0.51 (95% CI, 0.47-0.56) per million in 2008 to 2010 (P < .001).
The authors offered several possible explanations for the rise, including an increase in radiocontrast tests, which means more people are exposed to the risk of an allergic reaction to a radio-contrast agent.
The second biggest cause of fatal anaphylaxis over the study period was venom, but it was named the likely trigger on only 15.2 percent of the death certificates, according to HCP Live. Food was named on just 6.7 percent of death certificates as the probable cause for the anaphylactic attack.
The researchers found that older people had greater risk of fatal anaphylaxis from all causes (P < .001); and African-Americans faced greater risk of fatal anaphylaxis from medications, food and unspecified allergens (P < .001).