Pulmonary complications for predicting mortality among major burn victims

Abstract

Objective The aim of this study was to assess the incidence of early and late pulmonary complications among major burn victims and to study their effects on patient's outcome. Background Respiratory complications associated with burn injury are responsible for significant morbidity and mortality. Patients and methods Forty-two patients with major burn with no past history of pulmonary diseases were enrolled in the study. All patients were subjected to medical history taking, general, local (respiratory and burn), and upper airway examination, laboratory investigations, plain chest radiograph, and serial arterial blood gases analysis (initially after admission and then after 48 and 72 h). Results Pulmonary complications developed in 29 of 42 (69%) burned patients. Eleven of 42 (26.2%) patients died; 10 (90.9%) of them died due to pulmonary complications and one (9.1%) patient died due to wound sepsis. Acute respiratory distress syndrome, inhalational injury, pneumonia, acute bronchitis, lung contusion, and hemothorax were early phase (within 48 h of admission) pulmonary complications, whereas pneumonia, lung collapse, and pulmonary embolism were late phase (after 48 h of admission) pulmonary complications. Lower serum albumin and more deep burn were independent risk factors for pulmonary complications, and pulmonary complications, decreased prothrombin time concentration, and lower serum albumin were independent risk factors for mortality in patients with major burns. Conclusion Lower serum albumin and more deep burns were independent risk factors for pulmonary complications, and pulmonary complications, decreased prothrombin time concentration, and lower serum albumin were independent risk factors for mortality in burned patients.