A population-based epidemiologic analysis of deaths from anaphylaxis in Florida


  • M. R. Simon,

    1. Departments of Internal Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, MI and, Allergy and Immunology Section, William Beaumont Hospital, Royal Oak, MI
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  • Z. D. Mulla

    1. Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX and, Department of Epidemiology and Biostatistics, University of South Florida College of Public Health, Tampa, FL, USA
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Michael R. Simon, MD
Allergy and Immunology Section
William Beaumont Hospital
Royal Oak, MI 48073


Background:  Previous US population-based epidemiologic studies of anaphylactic deaths have been limited by small populations and/or few deaths. The objective of this study was to determine the 10-year incidence of death from anaphylaxis in Florida and its descriptive epidemiology.

Methods:  Patients who died from anaphylaxis from 1996 to 2005 were identified from ICD-9 and ICD-10 codes on death certificates statewide. Age, race and gender-specific anaphylactic death rates were calculated.

Results:  There were 89 deaths among Florida residents. The individuals with autopsy confirmed diagnoses, and those with clinical diagnoses only, did not differ with regard to race, anaphylactic triggers or the clinical variables of lung and heart disease. Annual death rate for anaphylaxis in Florida was 5.02/10 000 000. The relative risk of death from anaphylaxis was 14.09 for individuals ≥65 years old (P = 0.0000002) and 6.38 for individuals 35–64 years old (P = 0.0019) compared with those who were 5–14 years of age. Deaths among Florida residents that occurred in emergency rooms or outpatient settings were 2.11 times as likely to be anaphylactic deaths than deaths that occurred in inpatient settings (P = 0.0026). The ratios of anaphylactic deaths to total deaths in March and April and in July and August were greater than the ratios for the other bimonthly periods (P = 0.02).

Conclusion:  Death from anaphylaxis in Florida was more likely to occur in older individuals, in an emergency department, and in the months of March and April and July and August.