@article{ref1,
title="Inpatient and post-discharge outcomes following inhalation injury among critically injured burn patients",
journal="Journal of burn care and research",
year="2021",
author="Witt, Cordelie E. and Stewart, Barclay T. and Rivara, Frederick P. and Mandell, Samuel P. and Gibran, Nicole S. and Pham, Tam N. and Arbabi, Saman",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Inhalation injury is associated with high inpatient mortality, but the impact of inhalation injury after discharge and on non-mortality outcomes are poorly characterized. To address this gap, we evaluated the effect of inhalation injury on post-discharge morbidity, mortality and hospital readmissions among patients who sustained burn injury, as well as on in-hospital outcomes for context.This was a retrospective cohort study of patients with cutaneous fire/flame burns admitted to a burn center intensive care unit from 1/1/2009-12/31/2015, with or without inhalation injury. Records were linked to statewide hospital admission and vital statistics databases to assess post-discharge outcomes. Mixed-effects Poisson regression was used to assess mortality, complications, and readmissions. The overall cohort included 830 patients with cutaneous burns; of these, 201 patients had inhalation injury. In-hospital mortality was 31% among inhalation injury patients versus 6% in patients without inhalation injury (adjusted OR 2.35; 95% CI 1.66-3.31). Inhalation injury was also associated with an increased risk of in-hospital pneumonia and tracheostomy (p<0.05 for all). Inhalation injury was not associated with greater post-discharge mortality, all-cause readmission, readmission for pulmonary diagnosis, or readmission requiring intubation. Among the subset of patients with bronchoscopy-confirmed inhalation injury (n=124; 62% of inhalation injuries), higher injury grade was not associated with greater inpatient or post-discharge mortality. Inhalation injury was associated with increased early morbidity and mortality, but did not contribute to post-discharge mortality or readmission. These findings have implications for shared decision-making with patients and families, and for estimating healthcare utilization after initial hospitalization.<p /> <p>Language: en</p>",
language="en",
issn="1559-047X",
doi="10.1093/jbcr/irab029",
url="http://dx.doi.org/10.1093/jbcr/irab029"
}