Inhalation injury as a prognostic factor for mortality in burn patients.

ABSTRACT

Inhalation injury greatly increases the incidence of respiratory failure and acute respiratory distress syndrome. It is also the cause of most early deaths in burn victims. The aim of this research is to study the incidence, early diagnosis, complications, and management of inhalation injury and to discuss the relationship between inhalation injury and death in burn patients. The study included 130 burn patients (61 male and 69 female) with inhalation injury admitted to Menoufiya University Hospital Burn Center & Chest Department (Egypt) from January 2008 to January 2010. It was found that the presence of inhalation injury, increasing burn size, and advancing age were all associated with increased mortality (p < 0.01). The incidence of inhalation injury was 46.3% (the 130 patients came from a total number of 281 burn victims). The overall mortality rate among patients with inhalation injury was 41.5% (54/130) compared with 7.2% (11/151) among patients without inhalation injury. These statistics clearly indicate that inhalation injury was an important factor for predicting burn patient mortality. Approximately 80% of fire-related deaths are due not to the airway burn injury itself but to the inhalation of toxic products, especially carbon monoxide and hydrogen cyanide gases. Inhalation injury is generally caused by thermal burns, and is mostly confined to the upper airways. Major airway, pulmonary, and systemic complications occur after inhalation injury, and this increases the incidence of mortality among burn patients.