Outcomes following traumatic inhalational airway injury – Predictors of mortality and effect of procedural intervention

Neil N. Luu, Harman S. Parhar, Louis Xavier Barrette, Kevin Chorath, Alvaro Moreira, Karthik Rajasekaran

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3320-3326
Number of pages7
JournalInjury
Volume52
Issue number11
DOIs
StatePublished - Nov 2021

Keywords

  • Airway
  • Airway obstruction
  • Burns
  • Inhalation injury
  • National trauma database
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

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