We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Inpatient and Postdischarge Outcomes Following Inhalation Injury Among Critically Injured Burn Patients.
- Authors
Witt, Cordelie E; Stewart, Barclay T; Rivara, Frederick P; Mandell, Samuel P; Gibran, Nicole S; Pham, Tam N; Arbabi, Saman
- Abstract
Inhalation injury is associated with high inpatient mortality, but the impact of inhalation injury after discharge and on non-mortality outcomes is poorly characterized. To address this gap, we evaluated the effect of inhalation injury on postdischarge morbidity, mortality, and hospital readmissions among patients who sustained burn injury, as well as on in-hospital outcomes for context. This was a retrospective cohort study of patients with cutaneous fire/flame burns admitted to a burn center intensive care unit from January 1, 2009 to December 31, 2015, with or without inhalation injury. Records were linked to statewide hospital admission and vital statistics databases to assess postdischarge outcomes. Mixed-effects Poisson regression was used to assess mortality, complications, and readmissions. The overall cohort included 830 patients with cutaneous burns; of these, 201 patients had inhalation injury. In-hospital mortality was 31% among inhalation injury patients vs 6% in patients without inhalation injury (adjusted OR 2.35; 95% CI 1.66-3.31). Inhalation injury was also associated with an increased risk of in-hospital pneumonia and tracheostomy (P < .05 for all). Inhalation injury was not associated with greater postdischarge mortality, all-cause readmission, readmission for pulmonary diagnosis, or readmission requiring intubation. Among the subset of patients with bronchoscopy-confirmed inhalation injury (n = 124; 62% of inhalation injuries), a higher injury grade was not associated with greater inpatient or postdischarge mortality. Inhalation injury was associated with increased early morbidity and mortality, but did not contribute to postdischarge mortality or readmission. These findings have implications for shared decision making with patients and families and for estimating healthcare utilization after initial hospitalization.
- Subjects
INHALATION injuries; BURN patients; PATIENT decision making; NUMERIC databases; BURN care units; PATIENT readmissions; TREATMENT for burns &; scalds; LENGTH of stay in hospitals; PATIENT aftercare; HOSPITAL patients; BURNS &; scalds; SMOKE inhalation injuries; RETROSPECTIVE studies; MULTIPLE organ failure; CATASTROPHIC illness; BODY surface area; TREATMENT effectiveness; RESEARCH funding; DISCHARGE planning
- Publication
Journal of Burn Care & Research, 2021, Vol 42, Issue 6, p1168
- ISSN
1559-047X
- Publication type
journal article
- DOI
10.1093/jbcr/irab029