SCI
3 May 2020
Hospitalizations and Deaths Associated with EVALI
Werner A K, Koumans E H, Chatham-Stephens K, et al. Hospitalizations and Deaths Associated with EVALI[J]. N Engl J Med, 2020, 382(17): 1589-1598.
BACKGROUND 背景
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).
截至2020年1月7日，美国疾病控制和预防中心（CDC）共接到2558名非致命性和60名致命性电子烟使用相关肺损伤（EVALI）报告。
METHODS 方法
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.
在一项全国性的研究中，研究人员比较了EVALI致命病例和非致命病例的特征，以提高临床医生识别EVALI死亡风险的能力。卫生部门向疾控中心报告了EVALI病例的病历摘要和病人访谈的数据。研究人员还提供了三例因EVALI死亡的患者的病例报告，以分析这些患者共同的临床特征。
RESULTS 结果
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 withnonfatal 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.
致命或非致命性EVALI病例的大多数患者为男性（分别为32/60 [53%]和1666/2498 [67%]）。非西班牙裔白人（分别占39/49[80%]和1104/1818[61%]）的致死或非致命病例比例高于其他种族或族裔群体。35岁及以上（44/60 [73%]）的死亡病例比例高于35岁以下，但35岁及以上（551/2514 [22%]）的非死亡病例比例较低。对于已有病史患者，患有哮喘病史（13/57 [23%] vs 102/1297 [8%]）、心脏病病史（26/55 [47%] vs 115/1169 [10%]）或精神疾病（32/49 [65%]vs575/1398 [41%]）患者的死亡病例比例高于非致命病例。50例死亡病例中有26例（52%）有肥胖症。半数死亡病例（25/54[46%]）在住院或死亡前在门诊就诊。
CONCLUSIONS 结论
Chronic conditions, including cardiac and respiratory diseases and mental health conditions, were common among hospitalized patients with EVALI.
研究发现，慢性疾病，包括心脏、呼吸系统疾病以及精神疾病，在电子烟使用相关肺损伤住院患者中很常见。
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