title: Inhalation injury in burn patients: establishing the link between diagnosis and prognosis.
abstract: This study was to re-evaluate inhalation injury as a prognostic factor in burn patients and to determine the factors that should be considered when refining the definition of inhalation injury. A total of 192 burn patients (152 men, 40 women; mean age, 46.1±13.8 years) who were suspected to have an inhalation injury and underwent bronchoscopy between January 2010 and June 2012 were included in this prospective observational study. All patients underwent bronchoscopy within 24h of sustaining the burn. The bronchoscopic findings were classified as normal, mild, moderate, and severe. Mechanical ventilation was administered, when required. Age, percentage of TBSA burned, ABSI score, requirement of mechanical ventilation and PF ratio, but not inhalation injury, COHb level, and bronchoscopic grades, significantly differed between the survivors and non-survivors (p<0.05). Mechanical ventilation (adjusted odds ratio [OR]: 9.787) and severe inhalation injury on bronchoscopy (adjusted OR: 45.357) were independent predictors of mortality on multivariate logistic regression analysis. Inhalation injury diagnosed through history does not predict mortality from burns. Other components such as severity of inhalation injury determined using bronchoscopy, and administration of mechanical ventilation might help predict the morbidity and mortality of burn patients with inhalation injury and all of the factors should be considered when the definition of inhalation injury is refined.
authors.affiliation: Department of Emergency Medicine, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea.
authors.forename: Kicheol
authors.initials: K
authors.lastname: You
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea; Department of Surgery, Kangwon National University College of Medicine, Kangwondaehak 1 gil, Chuncheon-si, Gangwon-do 200-701, Republic of Korea.
authors.forename: Hyeong-Tae
authors.initials: HT
authors.lastname: Yang
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea. Electronic address: dohern@hallym.or.kr.
authors.forename: Dohern
authors.initials: D
authors.lastname: Kym
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea.
authors.forename: Jaechul
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea.
authors.lastname: HaejunYim
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea.
authors.forename: Yong-Suk
authors.initials: YS
authors.lastname: Cho
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Hur
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea.
authors.forename: Wook
authors.initials: W
authors.lastname: Chun
authors.affiliation: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 12, Beodeunaru-ro 7-gil (Youngdeungpo-dong 2-ga), Youngdeungpo-gu, Seoul 150-719, Republic of Korea.
authors.forename: Jong-Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D001999:Bronchoscopy; D002056:Burns / Q000150:complications / Q000401:mortality*; D002059:Burns, Inhalation / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D002263:Carboxyhemoglobin / Q000378:metabolism; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices
chemical_list: D002263:Carboxyhemoglobin
keywords: Bronchoscopy; Burns; Inhalation injury; Mechanical ventilation; Mortality; Multivariate logistic regression analysis