A study published in the Journal of Allergy and Clinical Immunology suggests that medications lead to fatal allergic reactions far more often than food or venom. Anaphylaxis is a life-threatening allergic reaction that can lead to airway blockage, cardiac arrest, respiratory arrest and shock. It is commonly caused by medications, food and venomous bites and stings.
The study, conducted by researchers from Albert Einstein College of Medicine and Weill-Cornell Medical College, looked at 2,458 anaphylaxis-related deaths that occurred between 1999 and 2010. The researchers used the US National Mortality Database to identify diagnostic codes on death certificates.
The researchers found that medications were by far the leading cause of anaphylaxis-related fatalities, and were identified as the trigger in 58.8 percent (1,446 cases) of the deaths. Additionally, they are the likely cause of 473 deaths caused by “unspecified” allergens. A number of the deaths triggered by medications did not identify the specific drug; out of the records that did name medications triggers, antibiotics were the most common and attributed to 149 deaths. One hundred deaths were blamed on radiocontrast agents used in diagnostic imaging, and 46 blamed on chemotherapy. Serum, opiates, antihypertensives, nonsteroidal anti-inflammatory drugs and anesthestics were among the less common triggers.
Researchers also found that the rate of death from medication-induced anaphylaxis increased during the study. In 1999, the incidence was 0.27 per million and in 2001 the rate was 0.51 per million. The authors discussed several explanations for this finding. In a statement that accompanied the study, they wrote “The increase in medication-related deaths caused by anaphylaxis likely relates to increased medication and radiocontrast use, enhanced diagnosis, and coding changes,”
Venom was the second leading cause of fatal anaphylaxis. This incidence, however, was far behind medications as the probable trigger in 15.2 percent of all the death certificates in the study. Food was an even less common trigger, accounting for 6.7 percent of the death certificates.
The researchers also examined the rate of fatal anaphylaxis in relation to several demographic factors, such as race and gender. The findings showed that the risk of dying from anaphylaxis in general increased with age and men had a higher risk of suffering a fatal anaphylaxis caused by venom. The risk of fatal anaphylaxis from medications, food and unspecified allergens was higher in African-Americans while the risk of fatal anaphylaxis from venom was greater in whites, the study said. The authors wrote that “There are strong and disparate associations between race and specific classes of anaphylaxis-related mortality in the United States,”