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PostPosted: Fri Aug 29, 2014 4:41 pm 
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Joined: Thu Dec 20, 2007 7:23 pm
Posts: 823
Location: Kingston
Study Identifies Factors that Contribute to Cases of Fatal Anaphylaxis

Quote:
New research into fatal cases of anaphylaxis concludes that teens and asthmatics with known allergies face particularly high risks and should make doubly sure to carry epinephrine auto-injectors.

The study authors, who just published their findings in Allergy, Asthma & Clinical Immunology, searched the Ontario (Canada) Coroner’s database from the years 1986 to 2011 and uncovered 92 fatal cases of anaphylaxis. They then mined the records further to obtain both the suspected trigger for each case and relevant patient demographics such as age, gender and co-morbidities.

Food allergies were the most common trigger, the cause of 40 total deaths. After that came insect venom (30 cases) and drugs or other medical treatment (16 cases). The trigger for 6 of the cases was unknown.

Slightly more than half of the patients (47) had experienced previous allergic reactions to whatever triggered their fatal anaphylaxis. More than a quarter (26) had documented asthma. Only 12 of the patients were children (mean age was 46.5 years) but 10 of the children were teenagers.

The percentage of patients with known cases of asthma was far higher in this study of fatal anaphylaxis than in most studies of all anaphylaxis or in the general public, and the true number of asthmatics in the study sample may have been far greater than 26. Only 2 of the patients were known not to have asthma. No information was available about which of the remaining 64 patients did and did not have asthma.



http://www.hcplive.com/articles/Study-I ... AtAJP.dpuf


The Study:

Anaphylaxis-related deaths in Ontario: a retrospective review of cases from 1986 to 2011

Quote:
Results

We found 92 deaths in the last 26 years related to anaphylaxis. Causes of death, in order of decreasing frequency, included food (40 cases), insect venom (30 cases), iatrogenic (16 cases), and idiopathic (6 cases). Overall, there appears to be a decline in the frequency of food related deaths, but an increase in iatrogenic causes of fatalities. We found factors associated with fatal anaphylaxis included: delayed epinephrine administration, asthma, allergy to peanut, food ingestion outside the home, and teenagers with food allergies.
Conclusions

Our findings indicate the need to improve epinephrine auto-injector use in acute reactions, particularly for teens and asthmatics with food allergies. In addition, education can be improved among food service workers and food industry in order to help food allergic patients avoid potentially fatal allergens. The increasing trend in iatrogenic related anaphylaxis is concerning, and requires monitoring and more investigation.


http://www.aacijournal.com/content/10/1/38/abstract

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Mary


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