Does inhalation injury increase the mortality rate in burn patients? Investigation of relationship between inhalation injury and severity of burn surface

Objective. Inhalation injury accounts for 20% to 80% of deaths in burn patients due to severe cardiopulmonary distress not seen in cutaneous injury alone.  However, there are few comparative studies or retrospective analyses of the injury severity or deaths of patients with inhalation injury. 

Methods. We evaluated 59 patients (31 with inhalation injury and 27 without inhalation injury) who had sustained a severe burn injury and were treated in the intensive care unit at our medical center from 2004 through 2006.  Of the 31 patients with inhalation injury, 14 (45.2%) died, and of the 27 without inhalation injury, 4 (16.7%) died. 

Results. We investigated specific aspects of the severity and mortality of burn patients. The median (mean) burn index in patients without and with inhalation injury were 45 and 50 points (17.9 and 34.4), and the median (mean) prognostic burn index scores between patients with and without inhalation injury were 88.5 and 55.5 points (86.8 and 69.4). The median (mean) prognostic burn index scores in surviving patients with and without inhalation injury were 49.5 and 67 points (60.0 and 70.0), which suggest that patients with inhalation injury sustained significantly more severe cutaneous burns than did patients without inhalation injury. 

Conclusions. We conclude that inhalation injury alone may be fatal, but many patients with inhalation injury also sustain more severe cutaneous burns, which can further increase the mortality rate.

inhalation injury, burn, burn index, mortality, prognostic burn index

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