title: Early onset pneumonia in patients with severely burned face and neck: a 5-year retrospective study.
abstract: Patients with face and neck burns (FNBs) often undergo prehospital intubation, or sustain inhalation injury which are risk factors for pneumonia in specific populations. Early onset pneumonia (EOP) might be caused by initial management. The primary goal of this study was to find risk factors for EOP in FNB patients. This is a retrospective, single-center trial. We screened all FNB patients for EOP with the Clinical Pulmonary Infection Score. Pneumonia diagnosis was with culture from a mini broncho-alveolar lavage. Potential risk factors for EOP were recorded. We included 152 patients, EOP was diagnosed in 58 (38.2%). EOP patients had a greater burned surface area median (20±17% vs. 10±17%; p<0.001), were more frequently intubated during prehospital care (65.5% vs. 21.3%; p<0.001), had more abnormal fiberoptic bronchoscopy at admission (58.6% vs. 19.1%; p=0.002) and a lower initial PaO2/FiO2 ratio (median 314±118.6 vs. 365±105.7; p=0.01). Multivariate analysis showed that only prehospital intubation was independently associated with EOP (odds ratio 3.6; 95% confidence interval, 1.34-10). Prehospital intubation appears to be an independent risk factor for EOP in severe burn patients. Assessments of the risk-benefit ratios of intubating and of not intubating those patients are indicated.
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France. Electronic address: jean.cotte@gmail.com.
authors: Jean
authors: J
authors: Cotte
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Bertrand
authors: B
authors: Prunet
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Pierre
authors: P
authors: Esnault
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Guillaume
authors: G
authors: Lacroix
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Erwan
authors: E
authors: D'aranda
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Pierre Julien
authors: PJ
authors: Cungi
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Philippe
authors: P
authors: Goutorbe
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Eric
authors: E
authors: Dantzer
authors: Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
authors: Eric
authors: E
authors: Meaudre
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000706:statistics & numerical data; D002056:Burns / Q000150:complications*; D005151:Facial Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications*; D011014:Pneumonia / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors