Predicting prognosis in thermal burns with associated inhalational injury: a systematic review of prognostic factors in adult burn victims

Abstract

Burn injuries are a significant problem with high associated morbidity and mortality. Those associated with inhalational trauma (IHT) may be associated with higher mortality, but studies on prognosis are small and underpowered. This study was designed to identify prognostic factors that increase the risk of death, to quantify this risk, and to identify existing prognostic models. An electronic search of English-language publications that identify prognostic risk factors in thermal burns including IHT was carried out. Each article was reviewed systematically, and data extraction, quality assessment, and summarization of the articles were performed. Thirteen articles that met the inclusion/exclusion criteria of this study were reviewed. Overall, the mortality rate among burn patients in this review was 13.9% (4-28.3%), with the mortality rate among those with IHT being 27.6% (7.8-28.3%). Those studies with multivariate analyses identified increasing %TBSA, presence of IHT, and increasing age as the strongest predictors for mortality in this patient population. It seems that %TBSA, presence of IHT, and age are the best predictors of mortality among the current published literature on burn prognosis.