National trends in emergency department visits and hospitalizations for food-induced anaphylaxis in US children.

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Food is the leading cause of anaphylaxis in children seen in emergency departments in the United States, yet data on emergency department visits and hospitalizations related to food-induced anaphylaxis are limited. The objective of our study was to examine national time trends of pediatric food-induced anaphylaxis-related emergency department visits and hospitalizations. We conducted an observational study using a national administrative claims database from 2005 through 2014. Participants were younger than 18years with an emergency department visit or hospitalization for food-induced anaphylaxis. Outcome measures of our study included time trends of pediatric food-induced anaphylaxis-related emergency department visits and hospitalizations, including observations (in an emergency department or a hospital unit), inpatient admissions, and intensive care unit admissions. During the study period, participants had 7310 food-induced anaphylaxis-related emergency department visits. Emergency department visits for food-induced anaphylaxis increased by 214% (P<.001); the highest rates were in infants and toddlers (age 0-2years). Rates of emergency department visits significantly increased in all age-groups, with the highest increase in adolescents (age 13-17years: 413%; P<.001). Peanuts accounted for the highest rates (5.85 per 100000 in 2014) followed by tree nuts/seeds (4.62 per 100000 in 2014). The greatest increase in rates of emergency department visits for food-induced anaphylaxis occurred with tree nuts/seeds (373.0% increase during the study period). The incidence of food-induced anaphylaxis has significantly increased over time in children of all ages. Food-induced anaphylaxis in children is an important national public health concern.