Abstract

BackgroundAnaphylaxis has been increasing in developed countries but there is very little published data on the burden of anaphylaxis and the pattern of adrenaline autoinjector (AAI) prescription from Asia. We aim to determine the incidence rates of anaphylaxis and prescription rates of AAI over the past decade in Hong Kong.MethodsUsing a centralized electronic database of Hong Kong’s sole public-funded healthcare provider, we obtained and analysed all patients between 2009 and 2019 with physician-reported diagnosis of anaphylaxis. Incidence rates were calculated using population statistics as the denominator. Patients’ prescriptions on discharge were collected to determine the AAI prescription rates.ResultsThe overall 10-year estimated incidence rate of anaphylaxis was 3.57 per 100,000 person-years. An increasing trend over time across both paediatric and adult populations from 2009 to 2014 was found, which remained stable until 2019. This was more marked among the paediatric population (paediatric vs adult incidence rate ratio in 2019: 3.51 [95% CI 1.12–2.66] vs 1.82 [95% CI 1.05–1.60]). There was an overall increasing rate of AAI prescription for patients admitted for anaphylaxis, but the overall AAI prescription rate was less than 15% and was significantly less likely to be prescribed for the adult compared to paediatric patients (36.5% vs. 89.4%, p < 0.001).ConclusionsAn increasing trend of anaphylaxis incidence rates over the past decade is evident in Asian populations, with a discrepantly low rate of AAI prescription, particularly in the adult patients.

Highlights

  • Anaphylaxis has been increasing in developed countries but there is very little published data on the burden of anaphylaxis and the pattern of adrenaline autoinjector (AAI) prescription from Asia

  • More than twofold increase in anaphylaxis incidence between 2009 and 2019 Between 2009 and 2019, there were a total of 2,854 patients admitted 2,961 times with a physicianreported diagnosis of anaphylaxis over the span of 11 years

  • The increase in the anaphylaxis incidence rates was more than twofold from 2009 to 2019, with a marked increase between 2013 and 2014 (2.80 to 4.44 per 100,000 population, respectively). This significant increase corresponded with an increasing incidence rate ratio of 1.96 in 2014 to 2.06 in 2019

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Summary

Introduction

Anaphylaxis has been increasing in developed countries but there is very little published data on the burden of anaphylaxis and the pattern of adrenaline autoinjector (AAI) prescription from Asia. We aim to determine the incidence rates of anaphylaxis and prescription rates of AAI over the past decade in Hong Kong. Anaphylaxis is defined as a potentially fatal, severe and systemic allergic reaction that occurs suddenly after contact with an allergy-causing substance [1]. Li et al Clin Transl Allergy (2020) 10:51 more accurate estimates of the true anaphylaxis burden in Asian countries. Time-trend analyses of anaphylaxis incidence across longer time periods, using a unifying methodology on a territory-wide population, have never previously been reported. We took an advantage of a comprehensive electronic records system to determine the incidence rates of anaphylaxis between 2009 and 2019 in Hong Kong and investigated the longitudinal trends of AAI prescriptions

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