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. 2025 May 8;18(6):101062.
doi: 10.1016/j.waojou.2025.101062. eCollection 2025 Jun.

Risk factors/cofactors for heightened anaphylaxis severity in Japanese adults: A 10-year single-center retrospective cohort study

Affiliations

Risk factors/cofactors for heightened anaphylaxis severity in Japanese adults: A 10-year single-center retrospective cohort study

Makoto Nojo et al. World Allergy Organ J. .

Abstract

Background: Anaphylaxis is a severe and life-threatening allergic reaction. Although the risk factors/cofactors for anaphylaxis vary between countries and regions, limited information is available on these factors within the Japanese context. Therefore, we aimed to discern risk factors/cofactors associated with heightened anaphylaxis severity in Japanese adults.

Methods: In total, 507 adult patients with anaphylaxis who visited our clinic (Tokyo, Japan) between January 2010 and June 2020 were included in the analysis. Data on patient backgrounds, clinical characteristics, and causative allergens were extracted from patients' medical records. We retrospectively analyzed information on patient background and clinical characteristics associated with an increased severity of anaphylaxis. Logistic regression modeling was used to identify background features and clinical characteristics that contribute to anaphylaxis severity.

Results: Multivariate analysis revealed that age, smoking history, asthma, and alcohol consumption at the onset of anaphylaxis were significant risk factors contributing to the increased severity of anaphylaxis. Moreover, drug-induced anaphylaxis was associated with heightened severity than food, anisakis and other allergens.

Conclusion: We successfully identified risk factors/cofactors contributing to the heightened severity of anaphylaxis among adults in Japan. Additionally, our findings suggest that alcohol consumption and smoking are related to anaphylaxis severity in adults. The insights derived from this study will assist in identifying more effective preventive measures and treatment strategies in clinical practice.

Keywords: Adult; Anaphylaxis; Augmentation factor; Disease severity; Smoking.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Age significantly influences anaphylaxis severity. Solid curves: fitted Loess curves with 95% confidence intervals in gray. The odds ratio for age demonstrated a 20.8% increase (95% CI: 3.89%–40.6%) in severe anaphylaxis for every 10-year age increment. Although the very older age group exhibited a non-linear relationship, severity increased with age, especially in the older age group.

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