News: EVALI hospitalizations occurred before the 2019 outbreak, research suggests

Research presented at the American Thoracic Society’s (ATS) 2020 virtual event suggests that hospitalizations due to e-cigarette and vaping associated lung injury (EVALI) likely began to occur long before the widely reported 2019 outbreak.

A retrospective analysis was conducted using data from the Agency for Healthcare Research and Quality (AHRQ)-Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample for 2016. The research looked at this data using ICD-10-CM coding guidelines for EVALI to find possible cases of the illness before the widespread 2019 cases. EVALI encounters were identified among patients with a primary diagnosis of lung related complications with a secondary diagnosis of e-cigarette use.

In total, 68,149 non-elective hospital admissions related to e-cigarette utilization and six cases of EVALI were identified for the sample year of 2016. The average age of found patients was 54.6 years and male predominant. The most common symptom was nonspecific abdominal pain, and an average hospital length of stay was 11 days. The data did not allow for assessment of weather the identified EVALI cases involved vaping THC products, which was found to be a major aspect of the 2019 cases.

This research suggests that EVALI was occurring earlier than when it began to be documented in 2019 during the outbreak. More research would need to be completed to find out if the cases from 2016 were using THC vaping products similar to those linked in the 2019 cases.

Editor’s note: The original research presented at the ATS 2020 Virtual event can be found here. Original CMS EVALI coding guidelines can be found here. ACDIS coverage of EVALI 2019 cases can be found here.