TY - JOUR
T1 - Outcomes following traumatic inhalational airway injury – Predictors of mortality and effect of procedural intervention
AU - Luu, Neil N.
AU - Parhar, Harman S.
AU - Barrette, Louis Xavier
AU - Chorath, Kevin
AU - Moreira, Alvaro
AU - Rajasekaran, Karthik
N1 - Publisher Copyright:
© 2021
PY - 2021/11
Y1 - 2021/11
N2 - Objective: Study outcomes, predictors of mortality, and effects of procedural interventions on patients following traumatic inhalational airway injury. Study: Design: Retrospective study. Setting: National Trauma Data Bank Methods: Patients over the age of eighteen admitted between 2008 and 2016 to NTDB-participating sites were included. In-hospital mortality and length of stay were the primary outcomes. Results: The final study cohort included 13,351 patients. History of active smoking was negatively associated with in-house mortality with an OR of 0.33 (0.25–0.44). History of alcohol use, and presence of significant medical co-morbidities were positively associated with in-house mortality with OR of 5.28 (4.32–6.46) 2.74 (19.4–3.86) respectively. There was little to no association between procedural interventions and in-house mortality. Intubation, laryngobronchoscopy, and tracheostomy had OR of 0.90 (0.67–1.20), 1.02 (0.79–1.30), and 0.94 (0.58–1.51), respectively. However, procedural intervention did affect both the median hospital and ICU lengths of stay of patients. Median hospital and ICU length of stay were shorter for patients receiving endotracheal intubation. Median hospital length of stay was longer for patients undergoing bronchoscopy and laryngoscopy, but median ICU length of stay was shorter for patients undergoing bronchoscopy and laryngoscopy. Patients receiving a tracheostomy have both significantly increased median hospital and ICU lengths of stay. Conclusions: Active smoking was associated with decreased odds of in-hospital mortality, while presence of pre-existing medical comorbidities and history of alcohol use disorder was associated with increased odds of in-hospital mortality. Procedural intervention had little to no association with in-hospital mortality but did affect overall hospital and ICU LOS.
AB - Objective: Study outcomes, predictors of mortality, and effects of procedural interventions on patients following traumatic inhalational airway injury. Study: Design: Retrospective study. Setting: National Trauma Data Bank Methods: Patients over the age of eighteen admitted between 2008 and 2016 to NTDB-participating sites were included. In-hospital mortality and length of stay were the primary outcomes. Results: The final study cohort included 13,351 patients. History of active smoking was negatively associated with in-house mortality with an OR of 0.33 (0.25–0.44). History of alcohol use, and presence of significant medical co-morbidities were positively associated with in-house mortality with OR of 5.28 (4.32–6.46) 2.74 (19.4–3.86) respectively. There was little to no association between procedural interventions and in-house mortality. Intubation, laryngobronchoscopy, and tracheostomy had OR of 0.90 (0.67–1.20), 1.02 (0.79–1.30), and 0.94 (0.58–1.51), respectively. However, procedural intervention did affect both the median hospital and ICU lengths of stay of patients. Median hospital and ICU length of stay were shorter for patients receiving endotracheal intubation. Median hospital length of stay was longer for patients undergoing bronchoscopy and laryngoscopy, but median ICU length of stay was shorter for patients undergoing bronchoscopy and laryngoscopy. Patients receiving a tracheostomy have both significantly increased median hospital and ICU lengths of stay. Conclusions: Active smoking was associated with decreased odds of in-hospital mortality, while presence of pre-existing medical comorbidities and history of alcohol use disorder was associated with increased odds of in-hospital mortality. Procedural intervention had little to no association with in-hospital mortality but did affect overall hospital and ICU LOS.
KW - Airway
KW - Airway obstruction
KW - Burns
KW - Inhalation injury
KW - National trauma database
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85115794693&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85115794693&partnerID=8YFLogxK
U2 - 10.1016/j.injury.2021.09.013
DO - 10.1016/j.injury.2021.09.013
M3 - Article
C2 - 34565616
AN - SCOPUS:85115794693
SN - 0020-1383
VL - 52
SP - 3320
EP - 3326
JO - Injury
JF - Injury
IS - 11
ER -