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. 2025 May 22;6(2):27.
doi: 10.3390/ebj6020027.

The Impact of Face and Neck Burns on Respiratory Complications and Mortality

Rares-Adrian Giurgiu  1 , Eliza-Maria Bordeanu-Diaconescu  2 , Andreea Grosu-Bularda  1 , Adrian Frunza  1   2 , Sabina Grama  2 , Raducu-Andrei Costache  1 , Carina-Ioana Cristescu  1 , Tiberiu-Paul Neagu  1   2 , Ioan Lascar  1 , Cristian-Sorin Hariga  1
Affiliations

The Impact of Face and Neck Burns on Respiratory Complications and Mortality

Rares-Adrian Giurgiu et al. Eur Burn J. .

Abstract

Face and neck burns present significant clinical challenges due to their proximity to the airway, predisposing patients to inhalation injuries and subsequent respiratory complications. In our cohort of 206 patients, facial and neck burns were associated with a markedly higher incidence of inhalation injury (34.8% vs. 2.8%), necessitating more frequent endotracheal intubation (51.9% vs. 14.1%). Furthermore, respiratory infections were significantly more common in patients with facial and neck burns (26.7% vs. 7%, p < 0.001), with respiratory secretion cultures revealing a predominance of Pseudomonas aeruginosa (39.58%), Acinetobacter baumanii (18.75%), and Klebsiella pneumoniae (6.25%). In contrast, patients without facial and neck burns primarily exhibited Pseudomonas aeruginosa (50%) in their cultures. These complications translated into a significantly increased mortality rate in patients with facial and neck burns (31.1% vs. 12.7%), with a reduced mean survival period (66.7 days vs. 84.3 days) and a 2.8-fold increase in the hazard of mortality. Additionally, older age emerged as a significant determinant for the development of respiratory infections. Multivariable model regression analysis revealed that only TBSA remained a consistent and independent predictor for adverse respiratory outcomes and increased mortality, while face and neck burns are more causally associated with TBSA.

Keywords: burn infection; facial burns; inhalation injury; respiratory infections.

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Conflict of interest statement

The authors have no conflicts of interest, and the work was not supported or funded by any drug company.

Figures

Figure 1
Figure 1
Distribution of patients according to burn etiology.
Figure 2
Figure 2
Distribution of patients according to TBSA.
See this image and copyright information in PMC

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