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Hereditary angioedema, emergency management of attacks by a call center

      Highlights

      • HAE may lead to substantial use of call center mainly driven by abdominal attacks.
      • Call center can dispatch EMS when edema attacks can be potentially life threatening.
      • The management of HAE attacks is shortened by the call center.
      • Use of ED and hospitalizations are reduced by the use of a national call center in HAE.

      Abstract

      Objective

      Hereditary angiœdema (HAE) is a rare autosomal dominant disease characterized by recurrent, unpredictable, potentially life-threatening swelling. Objective is to assess the management of the acute HAE attacks in the real life setting through a call center in France.

      Methods

      A pre-specified ancillary study of SOS-HAE, a cluster-randomized prospective multicenter trial, was conducted. HAE patients were recruited from 8 participating reference centers. The outcome of interest was the rate of hospitalization.

      Results

      onerhundred patients were included. The median (quartile) age was 38 (29–53) years, and 66 (66%) were female. Eighty (80%) patients had HAE type I, 8 (8%) had HAE type II and 12 (12%) patients had FXII-HAE. Fifty-one (51%) patients had experienced at least one time the call center during the follow-up. Nine over 166 (5%) attacks for 9 different patients resulted in hospital admission to the hospital (in the short-stay unit, ie, <24 h) during the follow-up period. During 2 years, there were 166 calls to call center for 166 attacks. All attacks were treated at home after call center contact.

      Conclusions

      Use of emergency departments and hospitalizations are reduced by the use of a coordinated national call center in HAE after therapeutic education program that promoted self-administration of specific treatment and use of call to call center.

      Trial registration

      clinicalTrials.gov identifier: NCT01679912

      Keywords

      Abbreviations:

      C1-INH (C1-Inhibitor), ED (Emergency department), FXII-HAE (Factor XII-hereditary angiœdema), HAE (Hereditary angiœdema), IQR (Interquartile range), SD (Standard deviation)
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