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过敏反应的流行病学:趋势仍在上升吗?

Epidemiology of anaphylaxis: is the trend still going up?

机构信息

Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier.

Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM.

出版信息

Curr Opin Allergy Clin Immunol. 2023 Oct 1;23(5):349-356. doi: 10.1097/ACI.0000000000000933. Epub 2023 Aug 2.

Abstract

PURPOSE OF REVIEW

To understand the current global scale of anaphylaxis and identify possible strategies to increase the accuracy of epidemiological data.

RECENT FINDINGS

Anaphylaxis mortality and morbidity statistics may gain new perspectives with the global implementation of the ICD-11. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk, and support decision-making to facilitate health care planning and implementation of public health measures to prevent anaphylaxis.

SUMMARY

The true rate of anaphylaxis is unknown due to a number of factors, such as misdiagnosis, miscoding and undernotification. Moreover, there is lack of information about anaphylaxis epidemiology in many countries. Difficulties on collecting accurate and comparable data should be acknowledged and anaphylaxis data can vary widely. Currently, most robust data are derived from hospitalization datasets and national mortality databases. Anaphylaxis accounts for up to 0.26% of overall hospital admissions. It is suggested that the number of hospital admissions for anaphylaxis is increasing in many countries, both with respect to all-causes of anaphylaxis and by trigger, but the mortality rate remains low. However, there are still great challenges in capturing quality anaphylaxis mortality and morbidity statistics. Better understanding of anaphylaxis trends should clarify some areas of uncertainty about risk factors and prospect effective prevention strategies. As the knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to anaphylaxis in the ICD-11 will allow the collection of more accurate epidemiological data to support high quality management of patients, and to better facilitate health care planning to implement public health measures, reduce the morbidity and mortality attributable to anaphylaxis.

摘要

综述目的

了解全球范围内过敏反应的规模,并确定可能的策略以提高流行病学数据的准确性。

最近的发现

过敏反应死亡率和发病率的统计数据可能会随着 ICD-11 在全球范围内的实施而获得新的视角。提高与过敏反应相关的流行病学数据质量应能阐明有关危险因素的一些不确定领域,从而更好地确定保护那些处于危险中的患者的策略,并为决策提供支持,以促进医疗保健规划和实施公共卫生措施以预防过敏反应。

总结

由于误诊、误码和漏报等多种因素,过敏反应的真实发生率尚不清楚。此外,许多国家缺乏过敏反应流行病学方面的信息。应认识到收集准确和可比数据的困难,并且过敏反应数据可能差异很大。目前,最可靠的数据来自住院数据集和国家死亡率数据库。过敏反应占总住院人数的 0.26%。有研究表明,在许多国家,无论是由于过敏反应的所有原因还是由于诱因,过敏反应的住院人数都在增加,但死亡率仍然很低。然而,在捕获高质量过敏反应死亡率和发病率统计数据方面仍存在巨大挑战。更好地了解过敏反应趋势应能阐明有关危险因素的一些不确定领域,并展望有效的预防策略。由于从人群中获得的知识是更现实决策的关键信息,因此在 ICD-11 中为过敏反应设立的新章节将能够收集更准确的流行病学数据,以支持患者的高质量管理,并更好地促进医疗保健规划以实施公共卫生措施,降低过敏反应导致的发病率和死亡率。

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