• Rita Galeiras, Leticia Seoane-Quiroga, and Sonia Pértega-Díaz.
• From the Critical Care Unit, Burn Unit (R.G.), Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Critical Care Unit (L.S.-Q.), Hospital Universitario Lucus Augusto, Lugo, Spain; and Clinical Epidemiology and Statistics Unit (S.P.-D.), Spanish Clinical Research Network (SCReN), Complexo Hospitalario Universitario A Coruña, A Coruña, Spain.
• J Trauma Acute Care Surg. 2020 Feb 1; 88 (2): 330-344.

BackgroundThe objective of our study was to perform a systematic review and meta-analysis aimed at assessing the prevalence of inhalation injury in burn patients and its prognostic value in relation to in-hospital mortality.MethodsWe searched the PubMed and EMBASE databases for noninterventional studies published between 1990 and 2018 investigating in-hospital mortality predictors among burn patients.The primary meta-analysis evaluated the association between inhalation injury and mortality. A secondary meta-analysis determined the global estimate of the prevalence of inhalation injury and the rate of mortality. Random effects models were used, and univariate meta-regressions were used to assess sources of heterogeneity. This study is registered in the PROSPERO database with code CRD42019127356.FindingsFifty-four studies including a total of 408,157 patients were selected for the analysis. A pooled inhalation prevalence of 15.7% (95% confidence interval, 13.4%-18.3%) was calculated.The summarized odds ratio of in-hospital mortality secondary to an inhalation injury was 3.2 (95% confidence interval, 2.5-4.3). A significantly higher odd of mortality was found among the studies that included all hospitalized burn patients, those that included a lower proportion of male patients, those with a lower mean total body surface area, and those with a lower prevalence of inhalation injury.ConclusionDespite our study's limitations due to the high risk of bias and the interstudy heterogeneity of some of our analyses, our results revealed a wide range of prevalence rates of inhalation injury and a significant association between this entity and in-hospital mortality in burn patients. However, this association is not significant if adjusted for disease severity.Level Of EvidenceSystematic review/meta-analysis, level III.

12 keywords...

hide…