887 Inhalation Injuries Evaluated on a Global Scale

TL;DR

This study analyzed global data on inhalation injuries in burn patients, finding they are linked to higher mortality and fewer surgeries.

Contribution

The study provides the first global analysis of inhalation injury incidence, treatment patterns, and outcomes using the WHO Global Burn Registry.

Findings

Inhalation injury patients had a 63% mortality rate and lower surgical intervention rates compared to non-inhalation injury patients.

Inhalation injuries were associated with a 2.65 times higher odds of mortality.

Flame-based injuries and older age were common among inhalation injury patients.

Abstract

Inhalation injuries pose serious harm to individuals sustaining burn injuries. Despite the severity of inhalation injuries, data on their global incidence, treatment patterns, and outcomes—especially in low-resource settings—are limited. This study aims to analyze the global impact of inhalation injuries and quantify their influence on mortality.

Entries from the WHO Global Burn Registry were stratified based on whether or not patients had inhalation injuries. Descriptive statistics for each cohort were presented for demographics, burn characteristics, facility characteristics, and disposition. Multivariable regression analysis quantified the influence of inhalation injury on mortality and the need for surgical intervention.

There were 1,382 cases of inhalation injury. Inhalation injury patients had significantly higher median TBSA (50% vs. 15%, P< 0.001), consisted of flame-based injuries (89%), were significantly older (P< 0.001), and were mostly males (54%). Inhalation injury patients underwent surgery at a significantly lower rate (34% vs. 55%, P< 0.001). A total of 63% of inhalation injury patients died due to their injuries. Multivariable logistic regressions demonstrated that inhalation injury significantly increased the odds of mortality (OR 2.65, 95%CI 2.16-3.25) and reduced the odds of surgical intervention (OR 0.58, 95%CI 0.50-0.66).

Patients with inhalation injuries are particularly susceptible to worse outcomes. Additional factors, such as the timing of tracheostomies should be explored as a modifiable factor that could improve patient outcomes.

The global burn community must prioritize the management of inhalation injuries, particularly in resource-limited settings. Enhancing critical care capacities, particularly access to ventilators, could improve survival rates in this vulnerable patient population.

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