Admission chest CT complements fiberoptic bronchoscopy in prediction of adverse outcomes in thermally injured patients

John S. Oh, Kevin K. Chung, Anthony Allen, Andriy I. Batchinsky, Todd Huzar, Booker T. King, Steven Wolf, Tyson Sjulin, Leopoldo C. Cancio

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

In burned patients, inhalation injury can result in progressive pulmonary dysfunction, infection, and death. Although bronchoscopy is the standard for diagnosis, it only assesses the proximal airway and does not provide a comprehensive analysis of pulmonary insult. Chest radiographs have not been proven helpful in diagnosis of inhalation injury. Our hypothesis is that a CT scan alone or in conjunction with bronchoscopy can be used as a prognostic tool for critically ill burn patients, especially those with inhalation injury. The authors performed a retrospective study of all patients admitted to the U.S. Army Institute of Surgical Research Burn Center between 2002 and 2008 with chest CT within 24 hours of admission. They divided subjects into two groups, those with evidence of inhalation injury on bronchoscopy and those without. They used a radiologist's score to assess the degree of damage to the pulmonary parenchyma. The primary endpoint was a composite of pneumonia, acute lung injury/acute respiratory distress syndrome, and death. The inhalation injury group consisted of 25 patients and the noninhalation injury group of 19 patients. Groups were not different in age, TBSA burned, and percentage full-thickness burn. By multiple logistic regression, detection of inhalation injury on bronchoscopy was associated with an 8.3-fold increase in the composite endpoint. The combination of inhalation injury on bronchoscopy and a high radiologist's score was associated with a 12.7-fold increase in the incidence of the composite endpoint. Admission CT assists in predicting future lung dysfunction in burn patients. (J Burn Care Res 2012;33:532-538).

Original languageEnglish (US)
Pages (from-to)532-538
Number of pages7
JournalJournal of Burn Care and Research
Volume33
Issue number4
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

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Bronchoscopy
Inhalation
Thorax
Wounds and Injuries
Lung
Burn Units
Acute Lung Injury
Adult Respiratory Distress Syndrome
Critical Illness
Pneumonia
Retrospective Studies
Logistic Models
Incidence
Infection

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Admission chest CT complements fiberoptic bronchoscopy in prediction of adverse outcomes in thermally injured patients. / Oh, John S.; Chung, Kevin K.; Allen, Anthony; Batchinsky, Andriy I.; Huzar, Todd; King, Booker T.; Wolf, Steven; Sjulin, Tyson; Cancio, Leopoldo C.

In: Journal of Burn Care and Research, Vol. 33, No. 4, 01.07.2012, p. 532-538.

Research output: Contribution to journalArticle

Oh, John S. ; Chung, Kevin K. ; Allen, Anthony ; Batchinsky, Andriy I. ; Huzar, Todd ; King, Booker T. ; Wolf, Steven ; Sjulin, Tyson ; Cancio, Leopoldo C. / Admission chest CT complements fiberoptic bronchoscopy in prediction of adverse outcomes in thermally injured patients. In: Journal of Burn Care and Research. 2012 ; Vol. 33, No. 4. pp. 532-538.
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