Investigating the potential to assess severe lung inhalation injuries using computed tomography

Zhan, Qiu; Cui, Pei; Pan, Yuchen; Dai, Zheng; Gong, Zhenyu; Xin, Haiming; Tang, Fang; Deng, C; Huang, Gaoxiang; Zhu, Fujun; Tong, Yalin

doi:10.1016/j.burns.2018.11.012

Cited by 1 publication

(1 citation statement)

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“…The Radiologist’s Score for Smoke Inhalation Injury (RADS) stratifies severity of inhalation injuries based on chest CT, and has shown correlation with clinical outcomes, especially when combined with bronchoscopy. 23 However, radiologic correlation with bronchoscopy findings have been limited overall, 23,24 and other limitations to CT include questionable optimal timing, time-consuming assessment, and limited correlation with other clinical findings. In the future, CT may be most useful for “virtual bronchoscopy,” in which a 3-dimensional images are reconstructed to be navigated as if using a bronchoscope.…”

Section: Discussionmentioning

confidence: 99%

Serious Inhalation Injuries From Military Operations in Afghanistan, Iraq, and Syria

Coulter

Mickelson

Dye

et al. 2020

J Intensive Care Med

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Objective: To characterize serious inhalation injuries seen during recent military operations, and assess whether bronchoscopic severity findings were associated with clinical presentation and outcomes. Methods: Service members who suffered inhalation injuries while deployed to Iraq, Afghanistan, or Syria from 2001-2018 were identified using ICD-9 and 10 codes from the Expeditionary Medical Encounter Database (EMED), which is abstracted from patient records in forward-deployed medical facilities. Further information including demographics, mechanism of injury, mortality, total burn surface area (TBSA), degree of facial burn, total Injury Severity Score (ISS), and first post-injury bronchoscopy notes were collected. Patients were excluded with ISS less than 16 or without sufficient details regarding bronchoscopy. Injuries were grouped based on bronchoscopic Abbreviated Injury Scores (AIS) into low-grade (AIS of 1), moderate-grade (AIS of 2), or high-grade (AIS of 3 or 4). Results: 91 patients met inclusion criteria, with no significant differences in age, gender, paygrade, or service branch between degrees of injury. There were no statistical correlations between grade of injury and battle versus non-battle injury, blast versus non-blast mechanism, TBSA, or degree of facial burn. High-grade injuries had significantly higher ISS than low or moderate-grade injuries. After adjusting for ISS, the odds ratio of death was 10.4 (95% CI 1.47 to 74.53) for those with high-grade and 3.7 (95% CI 0.45 to 32.30) for those with moderate-grade compared to low-grade injuries. Conclusion: In this cohort of deployed military members with inhalation injuries, initial bronchoscopic severity findings are strongly associated with mortality even after adjusting for ISS. The AIS may be an important prognostic tool in all of those with serious inhalation injuries.

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Section: Discussionmentioning

confidence: 99%