Inhalation injury in southwest China--the evolution of care.
OBJECTIVE
This study aims to review the changes in management of inhalation injury and the associated reduction in mortality over the past 2 decades.


METHODS
The records of burn patients with inhalation injury hospitalised in our institute from 1986 to 2005 were retrospectively analysed. The incidence of inhalation injury and the associated mortality were analysed. Meanwhile, the relationship of inhalation injury with age, total burn area, tracheostomy intubation and mechanical ventilation were studied.


RESULTS
The incidence of inhalation injury was 8.01% in the total 10 608 hospitalised burn patients during the 20 years surveyed. Inhalation injury was always associated with large-sized burn and was more common in adults. The incidence of tracheostomy and mechanical ventilation increased from 39.46 and 30.28% in the period from 1986 to 1995 to 70.12 and 39.74% from 1996 to 2005, respectively. The overall mortality of inhalation-injured burn patients was 15.88% compared with 0.82% of the non-inhalation group. The mortality of the burn patients with inhalation injury dropped from 25.29% during the first 10 years to 11.71% during the second decade (p<0.01). Mortality secondary to inhalation injury as the lead cause decreased from 14.56 to 6.29% (p<0.01).


CONCLUSIONS
The care of inhalation injury has made significant progress over the past 2 decades. The early diagnosis of inhalation injury, early airway control and pulmonary function assistance with mechanical ventilation contribute to the reduction of mortality.
Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China. logxw@hotmail.com
Gaoxing
G
Luo
Yizhi
Y
Peng
Zhiqiang
Z
Yuan
Yonglin
Y
Liu
Wenguang
W
Cheng
Yuesheng
Y
Huang
Xianchang
X
Li
Mark
M
Fitzgerald
Jun
J
Wu
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D015208:Smoke Inhalation Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D014139:Tracheostomy / Q000706:statistics & numerical data; D055815:Young Adult