Epidemiological Data on Anaphylaxis in French Emergency Departments
Corriger J1,2, Beaudouin E1, Rothmann R3, 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, Tanno LK14
1Allergy 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, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France
J Investig Allergol Clin Immunol 2019; Vol 29(5)
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.
Key words: Anaphylaxis, Emergency, Epidemiology, International Classification of Diseases (ICD), Management