Tanno Luciana Kase, Luong Pham Thao Van, Dieval Megane, Dunoyer Caroline, Lawson Djito Tevi, Molinari Nicolas, Annesi-Maesano Isabella, Demoly Pascal
Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France.
Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM, France.
World Allergy Organ J. 2024 Sep 5;17(9):100951. doi: 10.1016/j.waojou.2024.100951. eCollection 2024 Sep.
The understanding of risk factors related to severe anaphylaxis is key to implementing prevention strategies. We present the first French population-based nine-year anaphylaxis hospitalization study evaluating specific trends and factors related to severe anaphylaxis (SA), to support identification of phenotypes at-risk.
This study used descriptive data from the French hospitalization database for the years 2012-2021, and included all patients hospitalized with anaphylaxis using International Classification of Diseases (ICD)-10 codes listed as a primary diagnosis. SA were cases that either required a hospitalization in intensive care units or resulted in death. Potential risk factors were identified according to corresponding ICD codes, available as secondary data during the patient's hospitalization.
The average hospitalization rate of all cases of anaphylaxis (SA and non-SA) was 1.34/100,000/year, and rate of admissions for SA was 0.08/100,000/year. Among the 5463 SA, 37.7% had unspecified coding label, when trigger was not identified. For SA cases in which trigger was identified, most were related to drugs (45.6%), followed by food (9.3%) and insect sting (7.2%). Overall, admissions due to anaphylaxis (SA and non-SA) were more frequent in males (57%). However, when the trigger was drugs, the proportion was significantly higher in females. For children aged 5-9 years, the most common trigger for SA was food. Patients for which SA was triggered by insect stings were identified exclusively in the 10-14 years age group. Chronic spontaneous urticaria was associated with insect sting-induced anaphylaxis, regardless of the severity. Angioedema was associated with all causes of SA. Cases of anaphylaxis presenting with urticaria and angioedema included cases with identified and unidentified triggers. Asthma and a personal history of allergy were associated with drug- and food-induced anaphylaxis.
This is the first study to provide data on severe phenotypes of anaphylaxis in France. Data presented is key to the implementation of public health actions and preventive strategies to improve quality care.
了解与严重过敏反应相关的风险因素是实施预防策略的关键。我们开展了法国首个基于人群的为期九年的过敏反应住院研究，评估与严重过敏反应（SA）相关的特定趋势和因素，以支持识别高危表型。
本研究使用了2012 - 2021年法国住院数据库中的描述性数据，纳入了所有以国际疾病分类（ICD）-10编码列为主要诊断而住院的过敏反应患者。SA是指那些需要入住重症监护病房或导致死亡的病例。潜在风险因素根据相应的ICD编码确定，这些编码在患者住院期间作为次要数据提供。
所有过敏反应病例（SA和非SA）的平均住院率为1.34/100,000/年，SA的住院率为0.08/100,000/年。在5463例SA中，37.7%的病例编码标签未明确，即未识别出诱发因素。对于已识别出诱发因素的SA病例，大多数与药物有关（45.6%），其次是食物（9.3%）和昆虫叮咬（7.2%）。总体而言，过敏反应（SA和非SA）导致的住院在男性中更为常见（57%）。然而，当诱发因素是药物时，女性的比例显著更高。对于5 - 9岁的儿童，SA最常见的诱发因素是食物。仅在10 - 14岁年龄组中发现了由昆虫叮咬引发SA的患者。慢性自发性荨麻疹与昆虫叮咬诱发的过敏反应相关，无论严重程度如何。血管性水肿与所有SA病因相关。伴有荨麻疹和血管性水肿的过敏反应病例包括已识别和未识别诱发因素的病例。哮喘和个人过敏史与药物和食物诱发的过敏反应相关。
这是第一项提供法国过敏反应严重表型数据的研究。所呈现的数据对于实施公共卫生行动和预防策略以改善优质护理至关重要。
