# The Impact of Face and Neck Burns on Respiratory Complications and Mortality

## TL;DR

Burns to the face and neck increase the risk of respiratory complications and death due to inhalation injuries and infections.

## Contribution

This study identifies face and neck burns as a significant risk factor for respiratory complications and mortality, independent of total burn surface area.

## Key findings

- Patients with face and neck burns had a 34.8% incidence of inhalation injury compared to 2.8% in others.
- Respiratory infections were more common in patients with face and neck burns (26.7% vs. 7%).
- Mortality was significantly higher in patients with face and neck burns (31.1% vs. 12.7%).

## Abstract

Face and neck burns present significant clinical challenges due to their proximity to the airway, predisposing patients to inhalation injuries and subsequent respiratory complications. In our cohort of 206 patients, facial and neck burns were associated with a markedly higher incidence of inhalation injury (34.8% vs. 2.8%), necessitating more frequent endotracheal intubation (51.9% vs. 14.1%). Furthermore, respiratory infections were significantly more common in patients with facial and neck burns (26.7% vs. 7%, p < 0.001), with respiratory secretion cultures revealing a predominance of Pseudomonas aeruginosa (39.58%), Acinetobacter baumanii (18.75%), and Klebsiella pneumoniae (6.25%). In contrast, patients without facial and neck burns primarily exhibited Pseudomonas aeruginosa (50%) in their cultures. These complications translated into a significantly increased mortality rate in patients with facial and neck burns (31.1% vs. 12.7%), with a reduced mean survival period (66.7 days vs. 84.3 days) and a 2.8-fold increase in the hazard of mortality. Additionally, older age emerged as a significant determinant for the development of respiratory infections. Multivariable model regression analysis revealed that only TBSA remained a consistent and independent predictor for adverse respiratory outcomes and increased mortality, while face and neck burns are more causally associated with TBSA.