Epidemiology of anaphylaxis in Olmsted County: A population-based study
Epidemiology of anaphylaxis in Olmsted County: A population-based study
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DOI：
10.1016/s0091-6749(99)70392-1
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发表时间：
1999-08-01
影响因子：
14.2
通讯作者：
Silverstein, MD
中科院分区：
文献类型：
--
作者：
Yocum, MW;Butterfield, JH;Silverstein, MD
背景：如果要避免过敏反应的复发，了解过敏反应的临床特征及其诱因是很重要的。一般人群中过敏反应的发生率通常被低估，流行病学研究也很少。由于过敏反应的准确描述可以提高人们对这一问题的认识，我们调查了明尼苏达州奥姆斯特德县一般人群中过敏反应的流行病学。目的：本研究的目的是描述1983年至1987年奥姆斯特德县居民中过敏反应的流行病学。方法：这是一项回顾性的以人群为基础的队列研究。回顾性分析了1255名奥姆斯特德县居民的病历，这些居民通过计算机连接的医学诊断指数（罗切斯特流行病学研究）确定，以确定其临床发作符合速发型过敏反应标准的居民。我们确定了过敏反应的发生率和发生率、复发率、过敏反应的患病率、过敏反应的原因、转诊至过敏专科医生的频率、住院率和病死率。116名居民发生1次过敏反应，13名居民发生2次过敏反应，4名居民发生3次过敏反应。过敏反应发生率为30/100，000人年（95%可信区间，25-35），有110名居民一生中首次发生过敏反应在1983年至1987年期间，过敏反应的平均年发病率为21/10万人-年（95%置信区间，17-25）。53%的患者存在特应性，52%的患者获得过敏咨询。在68%的人群中发现了可疑的过敏原，最常见的是食物，药物或昆虫叮咬。结论：过敏反应的发生率低于1%，死亡病例极少。过敏症患者比非过敏症患者更容易发生过敏反应。过敏反应常常不被患者和医生所认识。
Background: Awareness of the clinical features of anaphylaxis and its causative triggers is important if recurrent episodes are to be avoided. The incidence of anaphylaxis in the general population is often underreported, and epidemiologic studies are few. Because an accurate profile of anaphylaxis could heighten awareness of this problem, we investigated the epidemiology of anaphylaxis in the general population of Olmsted County, Minn,Objective: The purpose of this study was to describe the epidemiology of anaphylaxis in Olmsted County residents from 1983 through 1987,Methods: This was a retrospective population-based cohort study. The medical records of 1255 Olmsted County residents identified by computer-linked, medical diagnostic indices (the Rochester Epidemiology Study) were reviewed retrospectively to identify residents whose clinical episodes met the criteria for anaphylaxis. We determined the incidence and rate of occurrence of anaphylaxis, rate of recurrence, prevalence of atopy, cause of anaphylaxis, frequency of referral to an allergy specialist, hospital admission rate, and case-fatality rate.Results: There were 133 residents who experienced 154 anaphylactic episodes during the 5-year period: 116 residents had 1 episode of anaphylaxis, 13 residents had 2 episodes, and 4 residents had 3 episodes. The anaphylaxis occurrence rate was 30 per 100,000 person-years (95% confidence interval, 25-35), There were 110 residents who had a first lifetime episode of anaphylaxis (that was medically evaluated) during the years 1983 to 1987, The average annual incidence rate of anaphylaxis was 21 per 100,000 person-years (95% confidence interval, 17-25). Atopy was present in 53% of the cohort, and allergy consultation was obtained in 52%. A suspect allergen was identified in 68% of the cohort, most frequently a food, medication, or insect sting. The hospitalization rate was 7%, and 1 patient died.Conclusion: The incidence of anaphylaxis is less than 1%, and death rarely occurs. People with atopy experience anaphylaxis more frequently than people without atopy. Anaphylaxis frequently is not recognized by patients and physicians.