{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:19:59Z","timestamp":1790813999575,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epidemiological data on fatal anaphylaxis are underestimated worldwide. Few Italian data do exist. The aims of the study are to determine the anaphylaxis mortality rate in Italy and its associations with demographic characteristics (gender, age, and geographical distribution), and to investigate which are the most common triggers of fatal anaphylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a descriptive study analyzing data reported to the National Register of Causes of Death database and managed by the Italian National Institute of Statistics for the years 2004\u20102016. An analytical method was developed to identify all the ICD\u201010 codes related to anaphylaxis deaths, which were divided into two classes: \u201cDefinite anaphylaxis deaths\u201d and \u201cPossible anaphylaxis deaths.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2004 through 2016, 392 definite anaphylaxis deaths and 220 possible anaphylaxis deaths were recorded. The average mortality rate for definite anaphylaxis, from 2004 to 2016, was 0.51 per million population per year. Definite fatal anaphylaxis was mostly due to the use of medications (73.7%), followed by unspecified causes (20.7%) and hymenoptera stings (5.6%). Concerning possible anaphylaxis deaths, the most common cause was venom\u2010stinging insect (51.4%). We did not find any data on food fatal anaphylaxis. Unspecified anaphylaxis accounted for 21%\u201028% of all cases, underlining the difficulty in accurately ascertaining the causes of fatal anaphylaxis and therefore in assigning the proper ICD\u201010 code.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study of anaphylaxis\u2010related mortality coming from an official database of the whole Italian population. However, the actual number of deaths by anaphylaxis, and their related triggers, is probably underreported, mostly due to limitations of the current recording system, and to a poor allergy education. Corrective actions should be undertaken for the benefit of the Health System.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.14352","type":"journal-article","created":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T10:30:32Z","timestamp":1588588232000},"page":"2644-2652","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Fatal anaphylaxis in Italy: Analysis of cause\u2010of\u2010death national data, 2004\u20102016"],"prefix":"10.1111","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9324-6039","authenticated-orcid":false,"given":"Maria Beatrice","family":"Bil\u00f2","sequence":"first","affiliation":[{"name":"Allergy Unit Department of Clinical and Molecular Sciences Polytechnic University of Marche Ancona Italy"},{"name":"Department of Internal Medicine University Hospital Ospedali Riuniti di Ancona Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Corsi","sequence":"additional","affiliation":[{"name":"Postgraduate School of Allergy and Clinical Immunology Universit\u00e0 Politecnica delle Marche Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9873-9695","authenticated-orcid":false,"given":"Matteo","family":"Martini","sequence":"additional","affiliation":[{"name":"Postgraduate School of Allergy and Clinical Immunology Universit\u00e0 Politecnica delle Marche Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Penza","sequence":"additional","affiliation":[{"name":"Allergy Unit IRCCS Ospedale Policlinico San Martino Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Grippo","sequence":"additional","affiliation":[{"name":"Integrated System for Health, Social Assistance and Welfare Istituto Nazionale di Statistica Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Bignardi","sequence":"additional","affiliation":[{"name":"Allergy Unit IRCCS Ospedale Policlinico San Martino Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.01.038"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12437"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13402"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13410"},{"key":"e_1_2_10_6_1","first-page":"163","article-title":"Epidemiology of anaphylaxis: contributions from the last 10\u00a0years","volume":"25","author":"Tejedor\u2010Alonso MA","year":"2015","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.10.029"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.02.014"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1002\/0470861193.ch10","article-title":"Fatal anaphylaxis in the UK, 1992\u20132001","volume":"257","author":"Pumphrey RSH","year":"2004","journal-title":"Novartis Found Symp"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.08.018"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12748"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e32830638c5"},{"key":"e_1_2_10_13_1","unstructured":"ISTAT. 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