因 EVALI 而住院和死亡的情况。
Hospitalizations and Deaths Associated with EVALI.
机构信息
From the National Center for Environmental Health (A.K.W., E.D.M.), the National Center for Chronic Disease Prevention and Health Promotion (E.H.K., S.E., E.E.P., P. Briss, B.A.K.), the National Center on Birth Defects and Developmental Disabilities (K.C.-S., M.L.D.), the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (P.P.S., I.G.), the National Center for Injury Prevention and Control (P.P.S., G.T.B., C.M.J., V.K.), the Center for Preparedness and Response (S.M.H.), the Agency for Toxic Substances and Disease Registry (E.A.K.), and the National Center for Emerging and Zoonotic Infectious Diseases (D.A.R., S.R.-S.), Centers for Disease Control and Prevention, and Emory University School of Medicine (E.A.K.) - all in Atlanta; the California Department of Public Health, Sacramento (C.A.); the Mississippi State Department of Health, Jackson (P. Byers); the Indiana State Department of Health, Indianapolis (C.R.C.); the Illinois Department of Public Health, Springfield (I.G.); the Minnesota Department of Health, St. Paul (S.M.H.); and the New York State Department of Health, Albany (K.A.N.).
出版信息
N Engl J Med. 2020 Apr 23;382(17):1589-1598. doi: 10.1056/NEJMoa1915314.
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.
背景
截至 2020 年 1 月 7 日，向疾病控制与预防中心（CDC）报告了 2558 例非致命电子烟或蒸气产品使用相关肺损伤（EVALI）住院患者和 60 例致命病例。
方法
在一项全国性研究中，我们比较了致命 EVALI 病例患者与非致命病例患者的特征，以提高临床医生识别病情死亡风险增加患者的能力。卫生部门向 CDC 报告 EVALI 病例，并在可能的情况下，从病历摘要和患者访谈中获取数据。分析包括截至 2020 年 1 月 7 日向 CDC 报告的所有致命或非致命 EVALI 病例。我们还报告了三例死于 EVALI 的患者的病例报告，以说明此类患者常见的临床特征。
结果
大多数致命或非致命 EVALI 病例患者为男性（32/60[53%]和 1666/2498[67%]）。致命或非致命病例患者中，非西班牙裔白人比例较高（39/49[80%]和 1104/1818[61%]）。致命病例患者中，35 岁或以上患者比例较高（44/60[73%]），而 35 岁以下患者比例较低，但非致命病例患者中，35 岁或以上患者比例较低（551/2514[22%]）。在有可用病史的患者中，致命病例患者中既往有哮喘（57/57[100%]）、心脏病（55/55[100%]）或心理健康状况（49/49[100%]）的比例高于非致命病例患者，而有这些病史的比例则较低（102/1297[8%]）、心脏病（115/1169[10%]）或心理健康状况（575/1398[41%]）。50 例致命病例患者中共有 26 例（52%）肥胖。一半致命病例患者（25/54[46%]）在住院或死亡前在门诊就诊。
结论
慢性疾病，包括心脏和呼吸疾病以及心理健康状况，在住院 EVALI 患者中很常见。
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