P0612 - Understanding Psychosocial Comorbidities in Adolescents with E-cigarette, or Vaping, Product-Use Associated Lung Injury (EVALI)

Introduction
Pediatric patients account for 15% of the total reported cases of E-cigarette, or Vaping, Product-Use Associated Lung Injury (EVALI) in the US. Psychosocial comorbidities such as home stressors, academic difficulty, psychiatric history, and polysubstance abuse are common among adolescents. We aimed to describe the psychosocial comorbidities in adolescents requiring hospitalization for management of EVALI.

Methods
We conducted a retrospective review of patients hospitalized for management of EVALI at a tertiary care, university-affiliated children’s hospital from 12/2018–12/2019. Patients meeting the CDC’s criteria for confirmed or probable EVALI were included. Demographic data, vaping history, and psychosocial variables were collected. Psychosocial elements were divided into six subcategories: home environment, education, behavioral, psychiatric history, nicotine use (other than vaping), and substance use (other than vaping).

Results
Fifteen patients met inclusion criteria. Eight (53%) were female with a median age of 16 years (range 13-18 years). Seven out of fifteen reported vaping for one year or more. Home stressors (abuse, single parent home, or home drug exposure) were reported in 8 (53%) patients, academic difficulty in 9 (60%), and 6 (40%) patients had behavioral problems at home or school. Eight (53%) patients reported nicotine use other than vaping, and 13 (87%) reported use of another non-nicotine drug outside of vaping. Five (33%) patients had a previously diagnosed substance-use disorder. Additionally, 8 patients (53%) reported history of previous depression and/or anxiety. Seven patients had a psychiatry consult placed during their admission.

Discussion/Conclusion
Study findings suggest that, at our institution, adolescents hospitalized for EVALI have a high prevalence of psychosocial conditions. Psychosocial comorbidities of all subcategories were identified in more than half of patients. Pediatricians should screen patients with EVALI for psychosocial comorbidities as a routine part of care. Future work includes comparing psychosocial stressors in EVALI patients to those in the general adolescent population.