A model that was developed to predict inhalation injury in patients with burn injuries was found to have excellent discrimination, according to a study published in Emergency Medicine Australasia. With no clear method for identifying patients at risk of inhalation injury or requiring intubation in the pre-hospital setting, investigators sought to identify pre-burn center factors associated with inhalation injury confirmed on bronchoscopy and to develop a prognostic model for inhalation injury. They defined inhalation injury as an Abbreviated Injury Scale of greater than 1 on bronchoscopy and developed a multivariable logistic regression prediction model based on pre-burn center factors. Their model—based on percent total body surface area burned, flame, enclosed space, face burns, hoarse voice, soot in mouth, and shortness of breath being predictive of inhalation injury—provided excellent discrimination, with an area under the curve of 0.87 (95% confidence interval, 0.84-0.91). At non-burn centers, 33% of patients with inhalation injury were intubated, compared with 54% by emergency medical services and 58% at burn centers.
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