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J Investig Allergol Clin Immunol 2019; Vol. 29(5): 357-364
© 2019 Esmon Publicidad
doi: 10.18176/jiaci.0348
ORIGINAL ARTICLE
Epidemiological Data on Anaphylaxis in French
Emergency Departments
Corriger J
1,2
, Beaudouin E
1
, Rothmann R
3
, Penven E
4,5
, Haumonte Q
1
, Thomas H
1
, Picaud J
1
,
Nguyen-Grosjean VM
1
, Corriger-Ippolito J
5,6
, Braun F
3
, De Talancé M
7
, Auburtin B
8
, Atain-Kouadio P
6
,
Borsa-Dorion A
9
, Baugnon D
10
, De Carvalho M
11
, Jaussaud R
2
, Nguyen-Thi PL
12
, Bollaert PE
13
,
Demoly P
14
, Tanno LK
14
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 anaphylaxis-
related 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
J Investig Allergol Clin Immunol 2019; Vol. 29(5): 357-364
doi: 10.18176/jiaci.0348
Resumen
Antecedentes:
La anafilaxia es un problema prioritario de salud pública en la comunidad mundial alergológica. Sin embargo, los datos
epidemiológicos disponibles de morbilidad y mortalidad son mejorables. Presentamos el primer estudio epidemiológico multicéntrico,
realizado en siete departamentos de urgencias franceses durante un año, que tuvo como objetivo identificar las cuestiones relevantes
para lograr cambios en futuras estrategias, nacionales e internacionales, que deriven en un mejor diagnóstico, tratamiento y prevención
de la anafilaxia.
Métodos:
Se trata de un estudio descriptivo que utilizó la información proveniente de las bases de datos de siete instituciones francesas
de salud pública, de la región de Lorena, desde enero hasta diciembre de 2015. Se buscaron nomenclatura y códigos relacionados con la
anafilaxia, de la Clasificación Internacional de Enfermedades (CIE-10), y los pacientes fueron validados clínicamente como casos de anafilaxia.
Resultados:
De los 202.079 ingresos en urgencias, 4.817 tenían códigos relacionados con la anafilaxia CIE-10, 323 de los cuales se
validaron clínicamente con el diagnóstico de anafilaxia. Aunque el 45,8% presentó criterios de gravedad, la adrenalina se prescribió