Long-Term Pulmonary Sequelae After Inhalation Injury: A Retrospective Case-Control Study

Abstract

Inhalation injury (INHI) has strong associations with increased rates of in-patient mortality and pneumonia. This study's aim is to review long-term pulmonary outcomes in INHI patients. We present a retrospective cohort of burn patients admitted to an ABA-certified burn unit. Burn patients with or without medically confirmed INHI who were admitted were studied. The control groups were ventilated patients (V) and nonventilated patients (NV). Primary study outcomes were rates of postdischarge pulmonary sequelae, including ineffective airway clearance, infections, shortness of breath, and malignancy. Secondary outcomes included rates of postdischarge surgeries and readmission, postdischarge nonpulmonary sequelae, and postdischarge days to pulmonary/nonpulmonary sequelae. The study population included 33 INHI, 45 V, and 50 NV patients. There were no significant differences in age (P = .98), sex (P = .68), % TBSA (P = .18), pulmonary comorbidity (P = .5), or smoking status (P = .92). Outpatient pulmonary sequelae were significantly higher for both INHI and V groups as compared to NV (21% and 17% vs 4%, P = .023, .043). The number of days from discharge to pulmonary sequelae was significantly shorter in the INHI group vs the V group (162 ± 139 vs 513 ± 314 days, P = .024). All other measures were not significant when comparing INHI to V or NV (P > .05). Both INHI and V groups resulted in higher rates of outpatient pulmonary sequelae independent of inpatient course as compared to NV. While outpatient pulmonary sequelae were not significantly different between INHI and V, the INHI patients presented with complaints earlier.