2001Nigerian Journal of Surgical ResearchOpen access

Inhalation Injury in Burns Patients in Ibadan

Ibitola Oluwatoyin Adigun, Odunayo M. Oluwatosin, S D Amanor-Boadu, Oladipo A Oluwole

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Abstract

Background: Inhalation injury is one of the most prominent determinants of mortality in major burn patients. This study was undertaken to ascertain the factors that could be used to predict the occurrence of inhalation injury in a burnt patient, with a view to alerting the burn care providers for a reappraisal of the management protocol in this category of patients. Method: A retrospective study of patients managed for burns in 2 years. Descriptive and logistic regression analyses were performed on the following variables of patients with burns; age, sex, aetiology, extent of the burns, presence or absence of inhalation injury and outcome. Result: One hundred and sixty four patients with a mean (S. D.) age of 25.0 (16.9) years suffered a total body surface area (TBSA) burn of 35.8% (S. D. 26.9). Twenty-seven (16%) sustained inhalation injury. Among those who suffered inhalation, mean (S. D) TBSA was 50.4% (25.1) while in those without inhalation injury, mean (S. D) TBSA was 32.9% (26.4). While the overall mortality was 36%, the mortality of patients with inhalation injury was 78%. Of the variables, age, sex, aetiology and TBSA, only TBSA could be used to predict an occurrence of inhalation injury. Conclusion: Reasons for the high mortality included lack of facilities for monitoring blood gasses as well as for ventilatory support and delays in early skin coverage. A high index of suspicion and knowledge of the appropriate management of inhalation injury are important for a good outcome. (Nig J Surg Res 2001; 3: 50 – 55) KEY WORDS: burns, inhalation injury

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Background: Inhalation injury is one of the most prominent determinants of mortality in major burn patients. This study was undertaken to ascertain the factors that could be used to predict the occurrence of inhalation injury in a burnt patient, with a view to alerting the burn care providers for a reappraisal of the management protocol in this category of patients. Method: A retrospective study of patients managed for burns in 2 years. Descriptive and logistic regression analyses were performed on the following variables of patients with burns; age, sex, aetiology, extent of the burns, presence or absence of inhalation injury and outcome. Result: One hundred and sixty four patients with a mean (S. D.) age of 25.0 (16.9) years suffered a total body surface area (TBSA) burn of 35.8% (S. D. 26.9). Twenty-seven (16%) sustained inhalation injury. Among those who suffered inhalation, mean (S. D) TBSA was 50.4% (25.1) while in those without inhalation injury, mean (S. D) TBSA was 32.9% (26.4). While the overall mortality was 36%, the mortality of patients with inhalation injury was 78%. Of the variables, age, sex, aetiology and TBSA, only TBSA could be used to predict an occurrence of inhalation injury. Conclusion: Reasons for the high mortality included lack of facilities for monitoring blood gasses as well as for ventilatory support and delays in early skin coverage. A high index of suspicion and knowledge of the appropriate management of inhalation injury are important for a good outcome. (Nig J Surg Res 2001; 3: 50 – 55) KEY WORDS: burns, inhalation injury

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Available abstract

Background: Inhalation injury is one of the most prominent determinants of mortality in major burn patients. This study was undertaken to ascertain the factors that could be used to predict the occurrence of inhalation injury in a burnt patient, with a view to alerting the burn care providers for a reappraisal of the management protocol in this category of patients. Method: A retrospective study of patients managed for burns in 2 years. Descriptive and logistic regression analyses were performed on the following variables of patients with burns; age, sex, aetiology, extent of the burns, presence or absence of inhalation injury and outcome. Result: One hundred and sixty four patients with a mean (S. D.) age of 25.0 (16.9) years suffered a total body surface area (TBSA) burn of 35.8% (S. D. 26.9). Twenty-seven (16%) sustained inhalation injury. Among those who suffered inhalation, mean (S. D) TBSA was 50.4% (25.1) while in those without inhalation injury, mean (S. D) TBSA was 32.9% (26.4). While the overall mortality was 36%, the mortality of patients with inhalation injury was 78%. Of the variables, age, sex, aetiology and TBSA, only TBSA could be used to predict an occurrence of inhalation injury. Conclusion: Reasons for the high mortality included lack of facilities for monitoring blood gasses as well as for ventilatory support and delays in early skin coverage. A high index of suspicion and knowledge of the appropriate management of inhalation injury are important for a good outcome. (Nig J Surg Res 2001; 3: 50 – 55) KEY WORDS: burns, inhalation injury

Key concepts: Medicine, Inhalation, Total body surface area, Etiology, Burn injury, Logistic regression, Burn center, Retrospective cohort study

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