Fatal anaphylaxis registries data support changes in the who anaphylaxis mortality coding rules

Abstract

Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction. The difficulty of coding anaphylaxis fatalities under the World Health Organization (WHO) International Classification of Diseases (ICD) system is recognized as an important reason for under-notification of anaphylaxis deaths. On current death certificates, a limited number of ICD codes are valid as underlying causes of death, and death certificates do not include the word anaphylaxis per se. In this review, we provide evidences supporting the need for changes in WHO mortality coding rules and call for addition of anaphylaxis as an underlying cause of death on international death certificates. This publication will be included in support of a formal request to the WHO as a formal request for this move taking the 11th ICD revision.

Food‐induced fatal anaphylaxis: From epidemiological data to general prevention strategies

“…However, this estimate is likely to be lower than the true rate of fatal anaphylaxis, due to under-diagnosis and under-notification. Fatal foodinduced anaphylaxis rates range from 0.03 to 0.3 deaths per million inhabitants per year, 5,[8][9][10][11][12][13] (Table 1). Fatal foodinduced anaphylaxis rates range from 0.03 to 0.3 deaths per million inhabitants per year, 5,[8][9][10][11][12][13] (Table 1).…”

“…However, this estimate is likely to be lower than the true rate of fatal anaphylaxis, due to under-diagnosis and under-notification. [7][8][9] In the majority of countries, the most common causes for fatal anaphylaxis are medication/iatrogenic triggers and foods; foods are the most common elicitors in children and young adults. Fatal foodinduced anaphylaxis rates range from 0.03 to 0.3 deaths per million inhabitants per year, 5,[8][9][10][11][12][13] (Table 1).…”

“…Estimates can differ widely depending on a number of variables. 5,[7][8][9] Anaphylaxis is an uncommon cause of death, [10][11][12] particularly for food, and is difficult to study because it is typically a community event, occurring outside the hospital environment. 2,3 Hospitalizations due to anaphylaxis are also increasing in many countries, [4][5][6] in particular in young children; these increases are noted particularly for medication and food triggers.…”

“…5,6 These reported increases probably reflect a true increase in the prevalence of allergic disease, but are also confounded by cumulative incidence of anaphylaxis, better awareness and recognition of anaphylaxis, and changes in anaphylaxis coding, in part due to modifications in the international classification of diseases. 5,[7][8][9] Anaphylaxis is an uncommon cause of death, [10][11][12] particularly for food, and is difficult to study because it is typically a community event, occurring outside the hospital environment. Severe anaphylaxis is unpredictable, which contributes to the high adverse impact of the diagnosis on health-related quality of life of individuals at risk of anaphylaxis.…”

Improving adrenaline autoinjector adherence: A psychologically informed training for healthcare professionals

“…1(p.835) International prevalence rates show increasing numbers of children, adolescents, and adults in Europe and the United States are being diagnosed with anaphylaxis. [2][3][4][5][6][7][8][9][10] However, diagnosis is difficult and anaphylaxis fatalities are probably underreported. 11 United Kingdom hospital admission data show a population prevalence of 7 per 100 000, a 615% increase from 1992-2012.…”