Increasing incidence of anaphylaxis in Hong Kong from 2009 to 2019 --
discrepancies of anaphylaxis care between adult and pediatric patients
Background: 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.
Objectives: We aim to determine the incidence rates of anaphylaxis and
prescription rates of AAI over the past decade in Hong Kong. Methods:
Using 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. Results: The overall 10-year
estimated incidence rate of anaphylaxis was 3.57 per 100,000
person-years. An increasing trend over time across both pediatric and
adult populations from 2009 to 2019 was found which was more marked
among the pediatric population. There was an overall increasing rates 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 pediatric patients
(36.5% vs. 89.4%, p<0.001). Conclusions: An 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.