Factors affecting prognosis of inhalation injury.

As care for burn injuries continue to improve, inhalation injuries have become a more significant cause of death. The purpose of this study was to evaluate factors affecting prognosis in patients with inhalation injuries. We undertook a retrospective chart review of all 829 consecutive patients admitted to our burn unit from January 2000 to September 2004. The 600 patients with thermal injury and no inhalation injury had a mortality of 3% (20/600). The 229 (28%) patients with an inhalation injury had an overall mortality of 16% (36/229; P < .001). Of these patients, 22 (10%) died in the first 48 hours, 90 (39%) were discharged in the first 48 hours, and 117 (51%) required hospitalization of at least 48 hours. Of the remaining 117 patients with inhalation injury the mortality was 12%. No difference in mortality (5% vs 3%) or length of stay (18 days vs 14 days) was seen between patients with an isolated inhalation injury and those with an inhalation injury plus an associated burn of less than 10% (P > .05). A significant difference was noted after the associated burn was larger then 10% (P < .05). The mortality rate and length of stay appear to be increased primarily by the severity of the associated burn in patients with inhalation injury andburns.