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Epidemiological data of anaphylaxis in french emergency departments

Corriger J*1,2, Beaudouin E1, Rothmann C3, Penven E4,5, Haumonte Q1, Thomas H1, Picaud J1, Nguyen-Grosjean VM1, Corriger-Ippolito J5,6, Braun F3, De Talancé M7, Auburtin B8, Atain-Kouadio P6, Borsa-Dorion A9, Baugnon D10, De Carvalho M11, Jaussaud R2, Nguyen-Thi PL12, Bollaert PE13, Demoly P14, Kase Tanno L14

1
Allergy Department, Hospital Emile Durkheim, Epinal, France
2Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France
3Emergency Department, Hospital Mercy–Metz, Ars-Laquenexy, France
4Occupational Diseases Department, University Hospital, Vandoeuvre-lès-Nancy, France
5Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France
6Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
7Emergency Department, Hospital Emile Durkheim, Epinal, France
8Pediatric Emergency Department, Hospital Emile Durkheim, Epinal, France
9Pediatric Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
10Emergency Department, Hospital of Verdun-Saint-Mihiel, Verdun, France
11Biology and Immunology Laboratory, University Hospital, Vandoeuvre-lès-Nancy, France
12Clinical Research Platform, ESPRI-BioBase Unit, University Hospital, Vandoeuvre-lès-Nancy, France
13Medical Intensive Care Unit, University Hospital, Nancy, France
14Division of Allergy, Department of Pulmonology, University of Montpellier,

J Investig Allergol Clin Immunol 2019; Vol. 29(5)
doi: 10.18176/jiaci.0348

Background: Although anaphylaxis has been pointed as a high priority public health issue in the allergy world community, morbidity and mortality epidemiological data are still not optimal. This first multi-centric epidemiological study performed in 7 French emergency departments for one year intended to map the key issues to substantiate the need for changes and support ongoing national and international efforts for better diagnosis, management and prevention of anaphylaxis.
Methods: This is a descriptive study using data routinely reported to French institutional administrative databases reported from 7 French public health  institutions of the Lorraine region from January to December 2015, based on International Classification of Diseases (ICD)-10 pre-selected anaphylaxis-related codes and clinically validated as anaphylaxis cases.
Results: From the 202,079 ED admissions, 4,817 had ICD-10 anaphylaxis-related codes, 323 of those have been clinically validated as anaphylaxis cases. Although 45.8% presented severity criteria, adrenaline has been prescribed only in 32.4% of these cases. Overall 323 cases, 57.9% were subsequently referred to allergy work-up or evaluation (after or during hospitalization) and 17.3% received a prescription of auto-injectable adrenaline.
Conclusion: Taken the results of this study, there is an urgent and pressing need for improved public health initiatives regarding anaphylaxis recognition and treatment.
Timely, we strongly believe that this document flags key problems, which may be managed in the forthcoming years by implementing national and international actions.

Key words: Anaphylaxis, Emergency, Epidemiology, International Classification of Diseases (ICD), Management