Common causes of emergency department visits for anaphylaxis in Korean community hospitals: A cross-sectional study

Anaphylaxis can cause death and requires immediate management. For prevention and education programs for anaphylaxis, it is important to be aware of the common triggering factors. We investigated the triggers of anaphylaxis in the emergency departments (EDs) of community hospitals in Korea. Patients who visited the EDs of 7 community hospitals for anaphylaxis from January 1, 2012 to December 31, 2016 were enrolled. Anaphylaxis was defined according to the World Allergy Organization criteria and identified via a thorough review of the medical records of patients who were diagnosed with anaphylaxis (ICD-10 codes: T780, T782, T805, and T886) at the ED or administered epinephrine in the ED. Triggers of anaphylaxis were also evaluated by a review of the medical records. We identified 1021 ED visits for anaphylaxis. The incidence of anaphylaxis ED visits was 0.08%. The triggers of ED visits for anaphylaxis were bee venom (55.0%), foods (21.3%), and drugs (13.2%); 9.6% of cases were idiopathic. However, food was the most common trigger among the patients aged <20 years old. The frequency of ED visits for anaphylaxis was highest in summer (47.9%), followed by autumn (28.2%), spring (12.3%), and winter (11.6%). The incidence of anaphylaxis ED visits was highest in August, during which bee venom was the trigger for 80% of anaphylaxis cases. For the 55 patients with repeat ED visits for anaphylaxis, Bee venom was also the most common trigger. The number of ED visits for anaphylaxis showed marked seasonal variation, peaking in summer. Bee venom was the most common trigger for adults and the main reason for seasonal variations of anaphylaxis ED visits in Korean community hospitals.