Hospitalizations and Deaths Associated with EVALI

Details

• Personal Author:
  Armatas C ; Baldwin GT ; Briss P ; Byers P ; Chatham-Stephens K ; Clark CR ; Danielson ML ; Ellington S ; Ghinai I ; Holzbauer SM ; Jones CM ; Kiernan EA ; King BA ; Koumans EH ; Krishnasamy V ; Moritz ED ; Navarette KA ; Petersen EE ; Reagan-Steiner S ; Rose DA ; Salvatore PP ; Werner AK
• Corporate Authors:
  Centers for Disease Control and Prevention (U.S.) Lung Injury Response Mortality Working Group
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Electrical Equipment And Supplies Epidemiology Flavoring Agents Lung Diseases Morbidity Mortality Nicotine Occupational Health Respiratory System Respiratory Tract Diseases Safety Smokers Solvents

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• Keywords:
  Electronic Devices Flavorings Lung Disease Morbidity Rates Mortality Data Respiratory Irritants Smoking Vapors
• ISSN:
  0028-4793
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; Georgia ; Indiana ; Mississippi ; New York ; OSHA Region 2 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  382
• Issue:
  17
• NIOSHTIC Number:
  nn:20066552
• Citation:
  N Engl J Med 2020 Apr; 382(17):1589-1598
• Contact Point Address:
  Dr. Werner, Centers for Disease Control and Prevention, 4770 Buford Hwy., MS S106-6, Atlanta, GA 30341
• Email:
  awerner@cdc.gov
• CAS Registry Number:
  (-)-Nicotine (CAS RN 54-11-5) ; 2H-1-Benzopyran-6-ol, 3,4-dihydro-2,5,7,8-tetramethyl-2-(4,8,12-trimethyltridecyl)-, 6-acetate (CAS RN 7695-91-2)
• Federal Fiscal Year:
  2020
• Performing Organization:
  Public Health Institute
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  New England Journal of Medicine
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:36285ea4f47bd595f0e2bfb4b5237c6599011493121661890d459a5fae9b506f1e2849a73612fb68d938d3618208ab3e5c0c936fa33e12db76a23c8133231417
• Download URL:
  https://stacks.cdc.gov/view/cdc/231120/cdc_231120_DS1.pdf
• File Type:
  [PDF - 381.06 KB ]