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EVALI相关的住院和死亡病例特征分析
2020-05-01 13:40

本期文章:《新英格兰医学杂志》:Vol.382 No.17

美国疾病控制和预防中心(CDC)Angela K. Werner小组分析了与EVALI有关的住院和死亡病例。相关论文发表在2020年4月23日出版的《新英格兰医学杂志》上。

截至2020年1月7日,CDC已收到2558例电子烟或蒸汽烟使用相关肺损伤(EVALI)非致命住院病例和60例致命病例的报告。在这项全国性研究中,研究组将EVALI致命病例和非致命病例的特征进行了比较,以帮助临床医生鉴别死亡风险较高的患者。

EVALI致命或非致命病例中大多数为男性,分别占53%和67%。致命或非致命病例中非西班牙裔白人占比最高,分别占80%和61%,远高于其他种族或民族。EVALI致命病例中,35岁以上患者占73%,远高于35岁以下患者;但在非致命病例中,35岁以上患者仅占22%,远低于35岁以下患者。

EVALI致命病例中,有病史的患者比例显著高于非致命性病例,包括哮喘病、心脏病或精神疾病。在50例致命病例中有26例(52%)患有肥胖症。46%的致命病例在住院或死亡前曾在门诊就诊。

总之,在住院的EVALI患者中,慢性疾病(包括心脏和呼吸系统疾病以及心理健康疾病)很常见。

附:英文原文

Title: Hospitalizations and Deaths Associated with EVALI

Author: Angela K. Werner, Ph.D.,, Emilia H. Koumans, M.D.,, Kevin Chatham-Stephens, M.D.,, Phillip P. Salvatore, Ph.D.,, Christina Armatas, M.D.,, Paul Byers, M.D.,, Charles R. Clark, M.P.H.,, Isaac Ghinai, M.B., B.S.,, Stacy M. Holzbauer, D.V.M.,, Kristen A. Navarette, M.D.,, Melissa L. Danielson, M.S.P.H.,, Sascha Ellington, Ph.D.,, Erin D. Moritz, Ph.D.,, Emily E. Petersen, Ph.D.,, Emily A. Kiernan, D.O.,, Grant T. Baldwin, Ph.D.,, Peter Briss, M.D.,, Christopher M. Jones, Pharm.D., Dr.P.H.,, Brian A. King, Ph.D.,, Vikram Krishnasamy, M.D.,, Dale A. Rose, Ph.D.,, and Sarah Reagan-Steiner, M.D.

Issue&Volume: 2020-04-22

Abstract: 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.

DOI: 10.1056/NEJMoa1915314

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1915314

期刊信息

The New England Journal of Medicine:《新英格兰医学杂志》,创刊于1812年。隶属于美国麻省医学协会,最新IF:70.67
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