エバリに関連した入院と死亡

Hospitalizations and Deaths Associated with EVALI.

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

抄録

背景:

2020年1月7日の時点で、電子タバコ（ベイピング）製品使用関連肺損傷（EVALI）の非致死的な症例の入院患者数は2558人、致死的な症例の入院患者数は60人の合計で、米国疾病対策予防センター（CDC）に報告されています。

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).

方法:

全国規模の研究では、臨床医が本疾患による死亡リスクの高い患者を特定する能力を向上させるために、EVALIの致死例と非致死例の患者の特徴を比較した。保健所はCDCにEVALIの症例を報告し、入手可能な場合には医療記録の抄録と患者面接のデータを含めた。解析には、2020年1月7日時点でCDCに報告されたEVALIの致死例または非致死例のすべての患者が含まれた。また、EVALIにより死亡した患者の3例の症例報告を提示し、そのような患者に共通する臨床的特徴を説明する。

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.

結果:

EVALIの致死的または非致死的症例のほとんどは男性であった（それぞれ60人中32人[53％]、2498人中1666人[67％]）。死亡例または非致死例の患者の割合は、非ヒスパニック系白人（それぞれ49人中39人[80％]、181818人中1104人[61％]）で、他の人種・民族の患者よりも高かった。致死例の割合は、35歳以上では35歳未満の若年者よりも高かったが（60歳中44人［73％］）、35歳以上では非致死例の割合が低かった（2514人中551人［22％］）。既往歴のある患者では、喘息（57人中13人［23％］対1297人中102人［8％］）、心疾患（55人中26人［47％］対1169人中115人［10％］）、または精神疾患（49人中32人［65％］対1398人中575人［41％］）の既往歴がある患者の方が、非死亡例よりも死亡例の割合が高かった。致死例の患者50人中26人（52％）に肥満があった。致死例の患者の半数（54人中25人［46％］）は、入院または死亡する前に外来を受診していた。

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.

結論:

心疾患や呼吸器疾患、精神疾患などの慢性疾患は、エバリの入院患者に多く見られた。

CONCLUSIONS: Chronic conditions, including cardiac and respiratory diseases and mental health conditions, were common among hospitalized patients with EVALI.

Copyright © 2020 Massachusetts Medical Society.