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The Outcomes Of Pediatric Inhalation Injuries In Lesser Burns: Still A Deadly Injury
*Salomon Puyana1, Samuel Ruiz1, Francisco Amador2, *Shaikh Hai1, Rizal Lim1, Morad Askari1, *Mark Mckenney1, Haaris Mir1
1Kendall Regional Medical Center, Miami, FL;2Universidad del Norte, Barranquilla, Colombia

Background: Its widely proposed inhalation injury worsens outcomes, yet no large-scale study has shown the relationship between inhalation injury and pediatric burns. Our study aimed to evaluate inhalation injuries in patients with limited burn injury. We hypothesize inhalation injury is associated with worse outcomes, even with limited burn injury.
Methods: 10-year retrospective review of the American Burn Association Registry 2002-2011. We compared the outcomes of pediatric patients that met our inclusion criteria: ≤15% total burn surface area (TBSA). We stratified patients into two groups: inhalation injury (group-1) vs. non-inhalation injuries (group-2). Demographics and outcome variables were compared. Outcome measures included in-hospital mortality rate, hospital length of stay (LOS), ICU LOS, and ventilator days.
Findings: A total of 29,439 patients meet inclusion criteria. We had 434 patients in group-1 and 29,005 patients in group-2. There was no statistical difference between the groups total TBSA 4.16% vs 4.15% (p=0.94, t-test) and partial-thickness TBSA 3.34% vs 3.59% (p=0.21, t-test) as shown in Table-1. There was a significantly higher ICU LOS at 5.58 days vs. 0.95 (p=0.0001, t-test). There was a significantly higher hospital LOS at 9.38 days vs. 4.47 (p=0.0001, t-test). Ventilator days were higher in group-1 at 3.74 vs. 0.18 (p<0.0001, t-test). The in-hospital mortality was significantly higher in group-1 at 3.92% vs 0.26% (p=0.0001, χ2).
Conclusions: Pediatric inhalation injuries was associated with an increased ICU LOS, in-hospital LOS and ventilator days and in-hospital mortality.

Results
Group 1 Inhalation Injury PresentGroup 2 No Inhalation Injuryp-value
Number of Patients43429,005
Mean Age (years)9.346.05<0.0001
Average Total TBSA (%)4.164.150.94
Average Partial TBSA (%)3.343.590.21
In-Hospital LOS (Days)9.384.47<0.0001
ICU-LOS (Days)5.580.95<0.0001
Average Ventilator Days3.740.18<0.0001
In-Hospital Mortality3.92%(17)0.26%(77)<0.0001


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