Rate of recurrent anaphylaxis and associated risk factors among Olmsted County, Minnesota, residents: A population-based study

Sangil Lee, Curtis Bashore, Christine M. Lohse, Fernanda Bellolio, Alanna Chamberlain, Kumi Yuki, Erik P. Hess, Ronna L. Campbell

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background The rate and risk factors for recurrence of anaphylaxis are not well known. Objective To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota. Methods We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010. We evaluated the rate and associations of risk factors with anaphylaxis recurrence. Results Among the 611 patients with anaphylaxis, 50 (8%) experienced a total of 60 recurrences within the 10-year period, resulting in a recurrence rate of 2.6 per 100 person-years. A history of atopic dermatitis (hazard ratio [HR], 5.6; 95% confidence interval [CI], 2.0–16.1; P = .001), presenting symptoms of cough (HR, 4.7; 95% CI, 2.1–10.7; P < .001) oral pruritus (HR, 9.9; 95% CI, 4.3–23.2; P < .001), and receiving corticosteroids (HR, 5.2; 95% CI, 2.3–11.7; P < .001) were associated with an increased risk of recurrence. The cardiovascular symptom of chest pain (HR, 0.24; 95% CI, 0.07–0.79; P = .02) was associated with a decreased risk of recurrence. Conclusion In this epidemiologic study, the rate of recurrence was 8% during the 10-year study period (recurrence rate of 2.6 per 100 person-years). Those with atopic dermatitis and mucocutaneous or respiratory symptoms were more likely to have a recurrent anaphylactic event. Our findings underscore the importance of early patient access to self-injectable epinephrine and referral to an allergist/immunologist for additional testing and education.

Original languageEnglish (US)
Pages (from-to)655-660.e2
JournalAnnals of Allergy, Asthma and Immunology
Volume117
Issue number6
DOIs
StatePublished - Dec 1 2016

Fingerprint

Anaphylaxis
Recurrence
Population
Confidence Intervals
Atopic Dermatitis
Medical Record Linkage
Pruritus
Chest Pain
Cough
Epinephrine
Epidemiologic Studies
Adrenal Cortex Hormones
Epidemiology
Cohort Studies
Referral and Consultation
Education
Injections

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Rate of recurrent anaphylaxis and associated risk factors among Olmsted County, Minnesota, residents : A population-based study. / Lee, Sangil; Bashore, Curtis; Lohse, Christine M.; Bellolio, Fernanda; Chamberlain, Alanna; Yuki, Kumi; Hess, Erik P.; Campbell, Ronna L.

In: Annals of Allergy, Asthma and Immunology, Vol. 117, No. 6, 01.12.2016, p. 655-660.e2.

Research output: Contribution to journalArticle

Lee, Sangil ; Bashore, Curtis ; Lohse, Christine M. ; Bellolio, Fernanda ; Chamberlain, Alanna ; Yuki, Kumi ; Hess, Erik P. ; Campbell, Ronna L. / Rate of recurrent anaphylaxis and associated risk factors among Olmsted County, Minnesota, residents : A population-based study. In: Annals of Allergy, Asthma and Immunology. 2016 ; Vol. 117, No. 6. pp. 655-660.e2.
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abstract = "Background The rate and risk factors for recurrence of anaphylaxis are not well known. Objective To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota. Methods We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010. We evaluated the rate and associations of risk factors with anaphylaxis recurrence. Results Among the 611 patients with anaphylaxis, 50 (8{\%}) experienced a total of 60 recurrences within the 10-year period, resulting in a recurrence rate of 2.6 per 100 person-years. A history of atopic dermatitis (hazard ratio [HR], 5.6; 95{\%} confidence interval [CI], 2.0–16.1; P = .001), presenting symptoms of cough (HR, 4.7; 95{\%} CI, 2.1–10.7; P < .001) oral pruritus (HR, 9.9; 95{\%} CI, 4.3–23.2; P < .001), and receiving corticosteroids (HR, 5.2; 95{\%} CI, 2.3–11.7; P < .001) were associated with an increased risk of recurrence. The cardiovascular symptom of chest pain (HR, 0.24; 95{\%} CI, 0.07–0.79; P = .02) was associated with a decreased risk of recurrence. Conclusion In this epidemiologic study, the rate of recurrence was 8{\%} during the 10-year study period (recurrence rate of 2.6 per 100 person-years). Those with atopic dermatitis and mucocutaneous or respiratory symptoms were more likely to have a recurrent anaphylactic event. Our findings underscore the importance of early patient access to self-injectable epinephrine and referral to an allergist/immunologist for additional testing and education.",
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T2 - A population-based study

AU - Lee, Sangil

AU - Bashore, Curtis

AU - Lohse, Christine M.

AU - Bellolio, Fernanda

AU - Chamberlain, Alanna

AU - Yuki, Kumi

AU - Hess, Erik P.

AU - Campbell, Ronna L.

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N2 - Background The rate and risk factors for recurrence of anaphylaxis are not well known. Objective To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota. Methods We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010. We evaluated the rate and associations of risk factors with anaphylaxis recurrence. Results Among the 611 patients with anaphylaxis, 50 (8%) experienced a total of 60 recurrences within the 10-year period, resulting in a recurrence rate of 2.6 per 100 person-years. A history of atopic dermatitis (hazard ratio [HR], 5.6; 95% confidence interval [CI], 2.0–16.1; P = .001), presenting symptoms of cough (HR, 4.7; 95% CI, 2.1–10.7; P < .001) oral pruritus (HR, 9.9; 95% CI, 4.3–23.2; P < .001), and receiving corticosteroids (HR, 5.2; 95% CI, 2.3–11.7; P < .001) were associated with an increased risk of recurrence. The cardiovascular symptom of chest pain (HR, 0.24; 95% CI, 0.07–0.79; P = .02) was associated with a decreased risk of recurrence. Conclusion In this epidemiologic study, the rate of recurrence was 8% during the 10-year study period (recurrence rate of 2.6 per 100 person-years). Those with atopic dermatitis and mucocutaneous or respiratory symptoms were more likely to have a recurrent anaphylactic event. Our findings underscore the importance of early patient access to self-injectable epinephrine and referral to an allergist/immunologist for additional testing and education.

AB - Background The rate and risk factors for recurrence of anaphylaxis are not well known. Objective To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota. Methods We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010. We evaluated the rate and associations of risk factors with anaphylaxis recurrence. Results Among the 611 patients with anaphylaxis, 50 (8%) experienced a total of 60 recurrences within the 10-year period, resulting in a recurrence rate of 2.6 per 100 person-years. A history of atopic dermatitis (hazard ratio [HR], 5.6; 95% confidence interval [CI], 2.0–16.1; P = .001), presenting symptoms of cough (HR, 4.7; 95% CI, 2.1–10.7; P < .001) oral pruritus (HR, 9.9; 95% CI, 4.3–23.2; P < .001), and receiving corticosteroids (HR, 5.2; 95% CI, 2.3–11.7; P < .001) were associated with an increased risk of recurrence. The cardiovascular symptom of chest pain (HR, 0.24; 95% CI, 0.07–0.79; P = .02) was associated with a decreased risk of recurrence. Conclusion In this epidemiologic study, the rate of recurrence was 8% during the 10-year study period (recurrence rate of 2.6 per 100 person-years). Those with atopic dermatitis and mucocutaneous or respiratory symptoms were more likely to have a recurrent anaphylactic event. Our findings underscore the importance of early patient access to self-injectable epinephrine and referral to an allergist/immunologist for additional testing and education.

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