title: Effect of inhalation injury, burn size, and age on mortality: a study of 1447 consecutive burn patients.
abstract: The relative impact of inhalation injury, burn size, and age on overall outcome following burn injury was examined in 1447 consecutive burn patients over a five and a half year period. The overall mortality for all patients was 9.5% (138 of 1447). The presence of inhalation injury, increasing burn size, and advancing age were all associated with an increased mortality (p < 0.01). The incidence of inhalation injury was 19.6% (284 of 1447) and correlated with increasing percent total body surface area (%TBSA) burn (r = 0.41, p < 0.01) and advancing age (r = 0.15, p < 0.01). The overall mortality for patients with inhalation injury was 31% (88 of 284) compared with 4.3% (50 of 1163) for those without inhalation injury. Using multivariate analysis inhalation injury was found to be an important variable in determining outcome, but the most important factor in predicting mortality was %TBSA burn (accuracy = 92.8%) or a combination of %TBSA burn and patient age (accuracy = 93.0%). Adding inhalation injury only slightly improved the ability to predict mortality (accuracy = 93.3%). The presence of inhalation injury is significantly associated with mortality after thermal injury but adds little to the prediction of mortality using %TBSA and age alone.
authors.affiliation: Department of Surgery, University of North Carolina, Chapel Hill 27707-7210.
authors.forename: D L
authors.initials: DL
authors.lastname: Smith
authors.forename: B A
authors.initials: BA
authors.lastname: Cairns
authors.forename: F
authors.initials: F
authors.lastname: Ramadan
authors.forename: J S
authors.initials: JS
authors.lastname: Dalston
authors.forename: S M
authors.initials: SM
authors.lastname: Fakhry
authors.forename: R
authors.initials: R
authors.lastname: Rutledge
authors.forename: A A
authors.initials: AA
authors.lastname: Meyer
authors.forename: H D
authors.initials: HD
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D002056:Burns / Q000401:mortality* / Q000473:pathology*; D002059:Burns, Inhalation / Q000401:mortality / Q000473:pathology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity