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12 Year Experience of Inhalation Injuries from House and Structure Fires
Christopher J. Fedor, MS; Mare G. Kaulakis, BS; Hilary Y. Liu, BS; Jose A. Arellano, MD; Garth A. Elias, MD; Alain C. Corcos, MD; Matthew P. Siedsma, MD; Jenny A. Ziembicki, MD; Francesco M. Egro, MD, MSc, MRCS
University of Pittsburgh, School of Medicine
2025-01-02
Presenter: Christopher J. Fedor
Affidavit:
I agree.
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
PURPOSE: Inhalation injuries from house and structure fires pose significant risks, including infection, inflammation, and multi-organ dysfunction. This study aims to identify and analyze key factors affecting clinical outcomes in this vulnerable population.
METHODS: We conducted a 12-year retrospective study (2012-2024) of patients treated at an ABA-certified burn center, excluding flash burns from smoking while on oxygen. Inhalation injury severity was measured using the Abbreviated Injury Score (AIS), and data on complications, ventilator days, and length of stay were collected.
RESULTS: Of 462 patients with house or structure fire injuries, 222 (48%) underwent diagnostic bronchoscopy, with 184 showing inhalation injury (75 mild, 79 moderate, 30 severe). The mean age was 54 ± 19 years, and most injuries occurred between November and January. Median total body surface area (TBSA) for burns was 1% (IQR: 0-14), and median carboxyhemoglobin was 11.8 (IQR: 5.9-26.8). Fifty patients had excision and grafting, with a median time to graft of 5 days (IQR: 3-6). Pneumonia was the most common complication (41.3%), and 34 patients died within one month (18.5%). Patients with moderate or severe injuries had hospital stays averaging 6.8 days longer (p = 0.008) and ventilator days averaging 5.7 days longer (p = 0.066) compared to those with mild injuries.
CONCLUSION: Inhalation injuries are often associated with carbon monoxide poisoning and minimal cutaneous burns. Severity of airway injury predicts ventilator days and length of stay, highlighting the importance of bronchoscopy evaluations. These outcomes can impact the timing of surgical intervention for patients requiring reconstructive procedures.
