Outcomes of Patients with Burns Associated with Home Oxygen Therapy: An Institutional Retrospective Review

Authors

Joshua S. Yoon, Division of Plastic, Reconstructive & Maxillofacial Surgery, R Adams Cowley Shock Trauma Center , Baltimore, MD, USA.
Kimberly H. Khoo, Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD, USA.
Joseph S. Puthumana, Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD, USA.
Lucas R. Pérez Rivera, The Johns Hopkins University , Baltimore, MD, USA.
Patrick R. Keller, Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD, USA.
Tomer Lagziel, Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD, USA.
Carrie A. Cox, Adult Burn Center, Johns Hopkins University Bayview Medical Center, Baltimore, MD, USA.
Julie Caffrey, Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD, USA.
Panagis Galiatsatos, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
C Scott Hultman, Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD, USA.

Document Type

Journal Article

Publication Date

7-2-2022

Journal

Journal of burn care & research : official publication of the American Burn Association

DOI

10.1093/jbcr/irac090

Keywords

Burns; Cigarettes; Home oxygen; Inhalational injury

Abstract

Home oxygen therapy (HOT) burns carry high morbidity and mortality. Many patients are active smokers, which is the most frequent cause of oxygen ignition. We conducted a retrospective review at our institution to characterize demographics and outcomes in this patient population. An IRB-approved single-institution retrospective review was conducted for home oxygen therapy burn patients between July 2016 and January 2021. Demographic and clinical outcome data were compared between groups. We identified 100 patients with oxygen therapy burns. Mean age was 66.6 years with a male to female ratio of 1.3:1 and median burn surface area of 1%. In these patients, 97% were on oxygen for COPD and smoking caused 83% of burns. Thirteen were discharged from the emergency department, 35 observed for less than 24 hours, and 52 admitted. For admitted patients, 69.2% were admitted to the ICU, 37% required intubation, and 11.5% required debridement and grafting. Inhalational injury was found in 26.9% of patients, 3.9% underwent tracheostomy, and 17.3% experienced hospital complications. In-hospital mortality was 9.6% and 7.7% were discharged to hospice. 13.5% required readmission within 30 days. Admitted patients had significantly higher rates of admission to the ICU, intubation, and inhalational injury compared to those that were not admitted (P < .01). Most HOT-related burns are caused by smoking and can result in significant morbidity and mortality. Efforts to educate and encourage smoking cessation with more judicious HOT allocation would assist in preventing these unnecessary highly morbid injuries.

APA Citation

Yoon, Joshua S.; Khoo, Kimberly H.; Puthumana, Joseph S.; Pérez Rivera, Lucas R.; Keller, Patrick R.; Lagziel, Tomer; Cox, Carrie A.; Caffrey, Julie; Galiatsatos, Panagis; and Scott Hultman, C, "Outcomes of Patients with Burns Associated with Home Oxygen Therapy: An Institutional Retrospective Review" (2022). GW Authored Works. Paper 1366.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1366

Department

School of Medicine and Health Sciences Resident Works