J Corriger1,2, E Beaudouin1, R Rothmann3, E Penven4,5, Q Haumonte1, H Thomas1, J Picaud1, V M Nguyen-Grosjean1, J Corriger-Ippolito5,6, F Braun3, M De Talancé7, B Auburtin8, P Atain-Kouadio6, A Borsa-Dorion9, D Baugnon10, M De Carvalho11, R Jaussaud2, P L Nguyen-Thi12, P E Bollaert13, P Demoly14, L K Tanno14. 1. Allergy Department, Hospital Emile Durkheim, Epinal, France. 2. Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France. 3. Emergency Department, Hospital Mercy-Metz, Ars-Laquenexy, France. 4. Occupational Diseases Department, University Hospital, Vandoeuvre-lès-Nancy, France. 5. Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France. 6. Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France. 7. Emergency Department, Hospital Emile Durkheim, Epinal, France. 8. Pediatric Emergency Department, Hospital Emile Durkheim, Epinal, France. 9. Pediatric Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France. 10. Emergency Department, Hospital of Verdun-Saint-Mihiel, Verdun, France. 11. Biology and Immunology Laboratory, University Hospital, Vandoeuvre-lès-Nancy, France. 12. Clinical Research Platform, ESPRI-BioBase Unit, University Hospital, Vandoeuvre-lès-Nancy, France. 13. Medical Intensive Care Unit, University Hospital, Nancy, France. 14. Division of Allergy, Department of Pulmonology, University of Montpellier, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France.
Abstract
BACKGROUND: Although anaphylaxis has been considered a priority public health issue in the world allergy community, epidemiological data on morbidity and mortality remain suboptimal. We performed the first multicenter epidemiological study in French emergency departments (EDs). The study covered 7 EDs over a period of 1 year. The objectives were to identify areas that are amenable to change and to support ongoing national and international efforts for better diagnosis, management, and prevention of anaphylaxis. METHODS: Ours was a descriptive study based on data routinely reported to French institutional administrative databases from 7 French public health institutions in the Lorraine region between January and December 2015. Data were collected based on the anaphylaxisrelated codes of the International Classification of Diseases (ICD)-10, and cases were clinically validated as anaphylaxis. RESULTS: Of the 202 079 admissions to the EDs, 4817 had anaphylaxis-related codes; of these, 323 were clinically validated as anaphylaxis. Although 45.8% were severe, adrenaline was prescribed in only 32.4% of cases. Of the 323 cases, 57.9% were subsequently referred for an allergy work-up or evaluation (after or during hospitalization), and 17.3% were prescribed autoinjectable epinephrine. CONCLUSION: Our results highlight an urgent need for improved public health initiatives with respect to recognition and treatment of anaphylaxis. We flag key problems that should be managed in the coming years through implementation of national and international actions.
BACKGROUND: Although anaphylaxis has been considered a priority public health issue in the world allergy community, epidemiological data on morbidity and mortality remain suboptimal. We performed the first multicenter epidemiological study in French emergency departments (EDs). The study covered 7 EDs over a period of 1 year. The objectives were to identify areas that are amenable to change and to support ongoing national and international efforts for better diagnosis, management, and prevention of anaphylaxis. METHODS: Ours was a descriptive study based on data routinely reported to French institutional administrative databases from 7 French public health institutions in the Lorraine region between January and December 2015. Data were collected based on the anaphylaxisrelated codes of the International Classification of Diseases (ICD)-10, and cases were clinically validated as anaphylaxis. RESULTS: Of the 202 079 admissions to the EDs, 4817 had anaphylaxis-related codes; of these, 323 were clinically validated as anaphylaxis. Although 45.8% were severe, adrenaline was prescribed in only 32.4% of cases. Of the 323 cases, 57.9% were subsequently referred for an allergy work-up or evaluation (after or during hospitalization), and 17.3% were prescribed autoinjectable epinephrine. CONCLUSION: Our results highlight an urgent need for improved public health initiatives with respect to recognition and treatment of anaphylaxis. We flag key problems that should be managed in the coming years through implementation of national and international actions.
Entities:
Keywords:
Anaphylaxis; Emergency; Epidemiology; International Classification of Diseases (ICD); Management
Authors: Stefania Arasi; Ulugbek Nurmatov; Audrey Dunn-Galvin; Shahd Daher; Graham Roberts; Paul J Turner; Sayantani B Shinder; Ruchi Gupta; Philippe Eigenmann; Anna Nowak-Wegrzyn; Mario A Sánchez Borges; Ignacio J Ansotegui; Montserrat Fernandez-Rivas; Stavros Petrou; Luciana Kase Tanno; Marta Vazquez-Ortiz; Brian P Vickery; Gary Wing-Kin Wong; Motohiro Ebisawa; Alessandro Fiocchi Journal: World Allergy Organ J Date: 2021-03-11 Impact factor: 4.084