Most patients with hereditary angioedema visited the ED in France because they were either running out of medication or were unaware emergency treatment could be administered at home, according to study results.
Nicolas Javaud, MD, MS, of the Assistance Publique–Hôpitaux de Paris, and colleagues conducted a multicenter prospective observational study of patients who consulted the ED at one of four reference centers for bradykinin-mediated angioedema from January 2011 to December 2013. They used this data to determine factors associated with hospital admission of patients with an acute hereditary angioedema (HAE) attack.
The researchers identified 57 attacks in 29 patients; 30% of the attacks led to hospital admission. Ten patients previously made a visit to the ED in the past year, and six of them were admitted to intensive care.
The primary locations of the acute attack prompting ED visits were the face (49%), abdomen (40%) and the larynx (32%).
Forty-six percent of patients ran out of emergency therapy at home leading to the ED visit, and 23% of patients were unaware the therapy could be self-administered.
Edemas of the larynx (OR = 18.6; 95% CI, 3.9-88) and face (OR = 7.7; 95% CI, 1.4-43.4) were associated with increased risks for hospital admission.
When patients self-injected subcutaneous icatibant before an ED visit, there was an 11-fold decreased risk for admission (OR = 0.06; 95% CI, 0.01-0.61).
The researchers acknowledged the small number of HAE attacks they reviewed limited their study, and that the results are not applicable to the general population.
“These findings cannot be generalized to all acute HAE attacks, such as the most severe attacks requiring direct admission to intensive care, on which the authors have no information,” the researchers wrote. – by Ryan McDonald
Disclosure: Javaud reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.