Key result
Prior cardiac disease and older age are strongly linked to fatal EVALI cases.
Why the study?
Characteristics of patients with fatal versus nonfatal EVALI cases were compared to improve clinical identification of patients at increased risk of death from EVALI.
What are the clinical characteristics associated with fatal versus nonfatal cases of EVALI?
Observational (n=2,618)
Yes
What are the clinical characteristics associated with fatal versus nonfatal cases of EVALI?
Patients who die from EVALI are significantly more likely to be older and have underlying chronic conditions, including cardiac disease, asthma, and mental health conditions, compared to those who survive.
Comorbidities including cardiac disease and asthma were linked to higher EVALI fatality risk; supports risk stratification but leaves open prospective validation.
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.
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A 2020 study conducted an observational in E-cigarette, or vaping, product use-associated lung injury (EVALI) (n=2,618). Fatal EVALI vs. Nonfatal EVALI was evaluated on Clinical characteristics and comorbidities. Fatal cases of EVALI were more likely than nonfatal cases to occur in patients aged ≥35 years (73% vs 22%) and those with a history of cardiac disease (47% vs 10%) or asthma (23% vs 8%).
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