Word count: 2456
Number of tables: 4
Number of figures : 2
Electronic Repository: 1 table
The Authors declare no potential conflict of interest for the present
paper.
The study received no funding.
Abstract – 249 words
Background – While the definition of anaphylaxis is clear, its grade of
severity remains a subject of debate, especially since different
published classifications provide different grading score, and the same
reaction may not receive the same score from different classifications.
The objective of this study was to evaluate the possible discrepancies
in severity scoring system for anaphylaxis in patients with a positive
food challenge (OFC), using the WHO for the 11thversion of the International Classification of Diseases (ICD-11) as the
main reference.
Methods – We conducted a retrospective observational study at the
University Hospital of Montpellier, France, including patients with a
positive OFC, between 2018 and 2022. We classified the severity of each
reaction, as per the ICD-11 classification, but also as per four other
widely used and validated classifications for grading anaphylaxis
severity.
Results – 235 patients presented a positive OFC between January 2018
and December 2022: 143 suffered from anaphylaxis, according to the
ICD-11 classification. 76.2% of them were classified as grade 2
according to the ICD-11 classification, and 23.8% as grade 3. When
comparing the different classifications, a complete concordance was
recorded in 8 patients (5.6%) only. All classifications showed a good
sensitivity (ranging from 99.3 to 100%), but different specificity
(from 67.4 to 93.5%), and discrepancies between them were shown in most
patients.
Conclusion – Our work highlights the need to refine the different
scoring systems, to accurately capture anaphylactic reactions and ensure
appropriate management, and, in the end, to adopt a universal,
intuitive, and easy-to-use classification, such as the ICD-11 one.
Keywords: adrenaline; anaphylaxis; classifications; ICD-11;
severity.