A NEWLY published study highlights a critical connection between inhalation injury severity and the risk of developing nosocomial pneumonia (NP) in burn patients. The retrospective cohort study analyzed 245 patients admitted to a regional burn center over 11 years. All patients underwent diagnostic bronchoscopy within 48 hours of admission to assess injury severity.
Findings revealed that patients with high-grade inhalation injuries (Abbreviated Injury Scale grades 3 and 4) had a significantly elevated risk of NP compared to those with low-grade injuries (grades 1 and 2). Among the 236 patients hospitalized for more than 48 hours, 48% of the high-grade group developed NP, versus 31% in the low-grade group and just 14% in those without inhalation injuries.
The analysis, adjusted for factors like age, burn size, and pre-existing obstructive lung disease, showed that high-grade inhalation injuries doubled the hazard of NP. Cause-specific hazard ratios (2.04, P = .004) and subdistribution hazard ratios (2.24, P = .001) confirmed this association.
This research underscores the importance of early identification and management of inhalation injuries in burn care. The authors call for further studies to explore mechanisms behind the injury-pneumonia link and to develop more effective prevention strategies.
Healthcare professionals managing burn patients are urged to consider the increased pneumonia risk in treatment planning, potentially incorporating targeted respiratory care and monitoring.
Reference: Coston TD et al. Severity of Inhalation Injury and Risk of Nosocomial Pneumonia. CHEST. 2024;166(6):1319-28.
Anaya Malik | AMJ
