D2.53 - Prevalence of angioedema in the emergency department at Sant Joan De Déu (Manresa)
Background
Angioedema (AE) is a subcutaneous and/or submucosal swelling that can have histaminergic, bradykinin-mediated, or idiopathic mechanisms. AE cases treated in emergency departments are often managed without distinguishing their underlying etiology.
Our objective was to determine the prevalence of AE cases in the Emergency Department, as well as their clinical characteristics and the administered treatments.
Method
Retrospective data were collected from emergency discharge reports at our center from 01/01/2018 to 12/31/2023, including diagnoses coded as Angioedema (T78.3), Urticaria (L50), Unspecified Allergy (T78.4), and Anaphylaxis (T78.2) based on ICD-9. Episodes were classified as histaminergic or non-histaminergic AE according to the clinical history described in the reports and their response to treatment. Administered treatments, treatment responses, and clinical outcomes post-discharge were recorded.
Results
During the study period, a total of 610,030 visits were recorded in the Emergency Department. Of these, 1,620 episodes met the inclusion criteria, representing 0.26% of all visits. The mean age was 38 years, with a female predominance (55.4%).
Clinical findings of angioedema were documented in 614/1,620 (37.9%) of the reviewed episodes. Based on clinical criteria, 88/614 (14.3%) were classified as non-histaminergic AE.
In 86% of cases, the treatment consisted of antihistamines and systemic corticosteroids, while adrenaline was administered in 9.1% of cases. For cases with inadequate response to initial treatment, C1-inhibitor concentrate was administered in 4.5%, and icatibant acetate in 3.4% of cases. 24.8% of non-histaminergic AE cases were referred to the Allergy Department.
Conclusion
The prevalence of patients presenting with AE in our Emergency Department was 0.1% for histaminergic and 0.01% for non-histaminergic.
Continued training of emergency physicians is necessary to ensure that the correct treatment is administered, to evaluate potential underlying causes, and to prevent recurrent episodes.
