Hospitalizations and Deaths Associated with EVALI
Angela K Werner1, Emilia H Koumans1, Kevin Chatham-Stephens1
1From 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.).
E-cigarette, or vaping, product use-associated lung injury (EVALI) disproportionately affected males and non-Hispanic white individuals. Fatal EVALI cases were more common in older adults with pre-existing conditions like asthma and cardiac disease.
Area of Science:
- Pulmonology
- Public Health
- Epidemiology
Background:
- E-cigarette, or vaping, product use-associated lung injury (EVALI) has emerged as a significant public health concern.
- As of January 7, 2020, the CDC reported 2558 nonfatal and 60 fatal cases of EVALI.
Purpose of the Study:
- To compare characteristics of fatal versus nonfatal EVALI cases.
- To enhance clinical identification of patients at higher risk of death from EVALI.
Main Methods:
- National study comparing fatal and nonfatal EVALI cases reported to the CDC.
- Data sourced from medical record abstractions and patient interviews.
- Analysis included all reported EVALI cases up to January 7, 2020, with three illustrative case reports.
Main Results:
- Fatal EVALI cases were more prevalent in males (53%) and non-Hispanic white individuals (80%).
- Older adults (≥35 years) had a higher proportion of fatal cases (73%) compared to nonfatal cases (22%).
- Pre-existing conditions such as asthma, cardiac disease, mental health conditions, and obesity were more common in patients with fatal EVALI.
Conclusions:
- Chronic conditions, including cardiac, respiratory, and mental health issues, were frequently observed in hospitalized EVALI patients.
- These findings highlight the importance of considering patient comorbidities in EVALI risk assessment.
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