Hospitalizations and Deaths Associated with EVALI.
Adolescent
Adult
Aged
Asthma
/ epidemiology
Comorbidity
Dronabinol
/ adverse effects
Electronic Nicotine Delivery Systems
Female
Heart Diseases
/ epidemiology
Hospitalization
/ statistics & numerical data
Humans
Lung Injury
/ complications
Male
Mental Disorders
/ epidemiology
Middle Aged
Overweight
/ epidemiology
Patient Acuity
United States
/ epidemiology
Vaping
/ adverse effects
Young Adult
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
23 04 2020
23 04 2020
Historique:
entrez:
23
4
2020
pubmed:
23
4
2020
medline:
29
4
2020
Statut:
ppublish
Résumé
As of January 7, 2020, a total of 2558 hospitalized patients with nonfatal cases and 60 patients with fatal cases of e-cigarette, or vaping, product use-associated lung injury (EVALI) had been reported to the Centers for Disease Control and Prevention (CDC). In a national study, we compared the characteristics of patients with fatal cases of EVALI with those of patients with nonfatal cases to improve the ability of clinicians to identify patients at increased risk for death from the condition. Health departments reported cases of EVALI to the CDC and included, when available, data from medical-record abstractions and patient interviews. Analyses included all the patients with fatal or nonfatal cases of EVALI that were reported to the CDC as of January 7, 2020. We also present three case reports of patients who died from EVALI to illustrate the clinical characteristics common among such patients. Most of the patients with fatal or nonfatal cases of EVALI were male (32 of 60 [53%] and 1666 of 2498 [67%], respectively). The proportion of patients with fatal or nonfatal cases was higher among those who were non-Hispanic white (39 of 49 [80%] and 1104 of 1818 [61%], respectively) than among those in other race or ethnic groups. The proportion of patients with fatal cases was higher among those 35 years of age or older (44 of 60 [73%]) than among those younger than 35 years, but the proportion with nonfatal cases was lower among those 35 years of age or older (551 of 2514 [22%]). Among the patients who had an available medical history, a higher proportion of those with fatal cases than those with nonfatal cases had a history of asthma (13 of 57 [23%] vs. 102 of 1297 [8%]), cardiac disease (26 of 55 [47%] vs. 115 of 1169 [10%]), or a mental health condition (32 of 49 [65%] vs. 575 of 1398 [41%]). A total of 26 of 50 patients (52%) with fatal cases had obesity. Half the patients with fatal cases (25 of 54 [46%]) were seen in an outpatient setting before hospitalization or death. Chronic conditions, including cardiac and respiratory diseases and mental health conditions, were common among hospitalized patients with EVALI.
Sections du résumé
BACKGROUND
As of January 7, 2020, a total of 2558 hospitalized patients with nonfatal cases and 60 patients with fatal cases of e-cigarette, or vaping, product use-associated lung injury (EVALI) had been reported to the Centers for Disease Control and Prevention (CDC).
METHODS
In a national study, we compared the characteristics of patients with fatal cases of EVALI with those of patients with nonfatal cases to improve the ability of clinicians to identify patients at increased risk for death from the condition. Health departments reported cases of EVALI to the CDC and included, when available, data from medical-record abstractions and patient interviews. Analyses included all the patients with fatal or nonfatal cases of EVALI that were reported to the CDC as of January 7, 2020. We also present three case reports of patients who died from EVALI to illustrate the clinical characteristics common among such patients.
RESULTS
Most of the patients with fatal or nonfatal cases of EVALI were male (32 of 60 [53%] and 1666 of 2498 [67%], respectively). The proportion of patients with fatal or nonfatal cases was higher among those who were non-Hispanic white (39 of 49 [80%] and 1104 of 1818 [61%], respectively) than among those in other race or ethnic groups. The proportion of patients with fatal cases was higher among those 35 years of age or older (44 of 60 [73%]) than among those younger than 35 years, but the proportion with nonfatal cases was lower among those 35 years of age or older (551 of 2514 [22%]). Among the patients who had an available medical history, a higher proportion of those with fatal cases than those with nonfatal cases had a history of asthma (13 of 57 [23%] vs. 102 of 1297 [8%]), cardiac disease (26 of 55 [47%] vs. 115 of 1169 [10%]), or a mental health condition (32 of 49 [65%] vs. 575 of 1398 [41%]). A total of 26 of 50 patients (52%) with fatal cases had obesity. Half the patients with fatal cases (25 of 54 [46%]) were seen in an outpatient setting before hospitalization or death.
CONCLUSIONS
Chronic conditions, including cardiac and respiratory diseases and mental health conditions, were common among hospitalized patients with EVALI.
Identifiants
pubmed: 32320569
doi: 10.1056/NEJMoa1915314
pmc: PMC8826745
mid: NIHMS1774925
doi:
Substances chimiques
Dronabinol
7J8897W37S
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1589-1598Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Investigateurs
Sondra Reese
(S)
Lynn E Sosa
(LE)
Adrienne Sherman
(A)
Caroline Judd
(C)
Thomas Troelstrup
(T)
Lee Hundley
(L)
Justin Blanding
(J)
Julie Hand
(J)
Lawrence C Madoff
(LC)
Rita Seith
(R)
George Turabelidze
(G)
Laura L Williamson
(LL)
Matthew A Donahue
(MA)
Stephen Perez
(S)
Tasha Poissant
(T)
Jeffrey R Miller
(JR)
Delphine Torbik
(D)
James Rajotte
(J)
Daniel Kilpatrick
(D)
Kelly Squires
(K)
Emily Hall
(E)
Varun Shetty
(V)
Nathaniel M Lewis
(NM)
Jonathan Falk
(J)
Lilian Peake
(L)
Mary E Evans
(ME)
Jennifer L Wiltz
(JL)
Benjamin C Blount
(BC)
Mateusz P Karwowski
(MP)
Maria Morel-Espinosa
(M)
Jon Rees
(J)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 Massachusetts Medical Society.
Références
N Engl J Med. 2000 May 4;342(18):1301-8
pubmed: 10793162
BMC Anesthesiol. 2015 May 06;15:56
pubmed: 25907273
MMWR Morb Mortal Wkly Rep. 2019 Nov 01;68(43):985-989
pubmed: 31671085
Subst Use Misuse. 2017 Jul 3;52(8):974-981
pubmed: 28323498
MMWR Morb Mortal Wkly Rep. 2019 Sep 13;68(36):784-786
pubmed: 31513559
MMWR Morb Mortal Wkly Rep. 2019 Oct 04;68(39):865-869
pubmed: 31581166
MMWR Morb Mortal Wkly Rep. 2019 Oct 04;68(39):860-864
pubmed: 31581168
JAMA Netw Open. 2018 Nov 2;1(7):e185293
pubmed: 30646397
N Engl J Med. 2020 Mar 5;382(10):903-916
pubmed: 31491072
MMWR Morb Mortal Wkly Rep. 2019 Nov 29;68(47):1096-1100
pubmed: 31774740
MMWR Morb Mortal Wkly Rep. 2019 Nov 22;68(46):1081-1086
pubmed: 31751322
Int J Environ Res Public Health. 2016 Dec 23;14(1):
pubmed: 28025560
MMWR Morb Mortal Wkly Rep. 2019 Nov 15;68(45):1034-1039
pubmed: 31725708
BMJ Open Respir Res. 2019 May 24;6(1):e000420
pubmed: 31258917
Circulation. 2014 May 13;129(19):1972-86
pubmed: 24821826
Lancet Respir Med. 2019 Dec;7(12):1017-1026
pubmed: 31711871
MMWR Morb Mortal Wkly Rep. 2019 Oct 18;68(41):919-927
pubmed: 31633675
Drug Alcohol Depend. 2014 Jan 1;134:228-234
pubmed: 24183498
MMWR Morb Mortal Wkly Rep. 2019 Nov 22;68(46):1076-1080
pubmed: 31751326
MMWR Morb Mortal Wkly Rep. 2019 Oct 25;68(42):953-956
pubmed: 31647788
JAMA. 2018 Feb 20;319(7):711-712
pubmed: 29466577
MMWR Morb Mortal Wkly Rep. 2020 Jan 24;69(3):90-94
pubmed: 31971931
Chest. 2018 Mar;153(3):702-709
pubmed: 28728934
Lancet. 2019 Dec 7;394(10214):2073-2083
pubmed: 31711629
Int J Gen Med. 2010 Oct 20;3:335-43
pubmed: 21116339
Int J Environ Res Public Health. 2015 Aug 21;12(8):9988-10008
pubmed: 26308021
Lancet Respir Med. 2019 Dec;7(12):1014-1015
pubmed: 32944502
Ann Am Thorac Soc. 2017 Jun;14(6):1050-1059
pubmed: 28570148
Chest. 2014 Dec;146(6):1426-1428
pubmed: 25451339
MMWR Morb Mortal Wkly Rep. 2020 Jan 03;68(5152):1189-1194
pubmed: 31895915