Descriptive epidemiology of hereditary angioedema emergency department visits in the United States, 2006‐2007

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Abstract:

Hereditary angioedema (HAE) is a rare inherited disorder of complement factor C1 inhibitor. In 2007 there were over 2000 HAE-related emergency department (ED) visits, nearly one-half of which culminated in a hospitalization. This study examines epidemiology and outcomes of hospital ED visits among HAE patients. We evaluated epidemiology, resource use, and discharge destinations of HAE (International Classification of Diseases, Version 9, clinical modification [ICD-9-CM] code 277.6) ED visits within the Nationwide Emergency Department Sample, part of Agency for Healthcare Research and Quality Healthcare Costs and Utilization Project, in 2006 and 2007. In 2006‐2007, there were 5040 ED visits with HAE, of which 2705 (53.7%) had HAE as the principal diagnosis (HAE-PD). The mean age for all HAE visits was 38.2 years, and women accounted for 56.5% of all HAE visits. When HAE was not the primary reason for the visit, abdominal pain was the most prevalent (10%) presenting diagnosis. Two thousand fifty-nine (40.9%) resulted in a hospitalization. Although of all HAE ED visits that did not require a hospitalization, the vast majority was discharged routinely home, further care either at a skilled nursing facility or at home was required after 45 (0.9%) of all the HAE visits and 10 (0.4%) of the HAE-PD visits. Mean HAE ED visits costs were $1479 (95% confidence interval, $1028‐1929). HAE ED visit volume is substantial. Although likely representing a fraction of the entire HAE population, prevention and acute treatment strategies aimed at those at risk for frequent exacerbations and disproportionate resource use need to be examined.

Keywords: Angioedema; costs; emergency department; epidemiology; hereditary angioedema; hospital; outcomes

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/aap.2011.32.3478

Affiliations: Department of of Biostastics and Epidemiology, University of Massachusetts, Amherst, Massachusetts, USA

Publication date: September 1, 2011

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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