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Abstract
Abstract Introduction Mortality in burn injury is primarily influenced by three factors: age, percent burn (%TBSA), and presence of inhalation injury. Numerous modalities have been tried in an attempt to treat those patients with burns and inhalation injury, including the use of hyperbaric oxygen (HBO). The aim of our study was to find the national prevalence of HBO for burns with inhalation injury, and whether HBO influenced mortality in these often severely injured patients. Methods This retrospective study used the National Burn Repository (NBR) to identify hospital admissions of patients with both cutaneous burns and inhalation injuries. After applying exclusion criteria, a total of 13,044 patients were identified. Variables included in the multivariate regression analysis included: age, sex, race, payer, mechanism of burn injury, TBSA group, total procedure number, mechanical ventilator days, and treatment with HBO. The main outcome variable was mortality. Results Of the 13,044 patients, 67 had HBO therapy. The HBO patients were older (mean age 51.7 years vs. 42.8 years, p< 0.001) but had smaller burns and thus a similar Baux score (66.6 vs. 65.2, p=0.661). The HBO patients had a higher mortality (29.9% vs. 17.5%, p= 0.01). On multivariate regression analysis, HBO was an independent predictor of mortality (OR= 2.484, p= 0.004). Other significant predictors of mortality included age, Black race, Medicaid or uninsured patients, and %TBSA. Conclusions The use of HBO for patients with burns and inhalation injury is uncommon in this database. It is unclear whether that reflects low prevalence or if individual centers do not all impute HBO into the NBR. For those patients in this database, HBO is an independent predictor of mortality. It can be difficult to determine the severity of inhalation injury in the NBR, so those patients receiving HBO could theoretically have more severe inhalation injury.
Published Version
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