TY  - JOUR
PY  - 2021//
TI  - Inpatient and post-discharge outcomes following inhalation injury among critically injured burn patients
JO  - Journal of burn care and research
A1  - Witt, Cordelie E.
A1  - Stewart, Barclay T.
A1  - Rivara, Frederick P.
A1  - Mandell, Samuel P.
A1  - Gibran, Nicole S.
A1  - Pham, Tam N.
A1  - Arbabi, Saman
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 1559-047X
UR  - http://dx.doi.org/10.1093/jbcr/irab029
ID  - ref1
ER  -