Abstract
Purpose: This retrospective study was conducted to verify the effectiveness of initial chest computed tomography (CT) to predict severity in patients with inhalation injury. Methods: We measured bronchial wall thickness on the initial CT scan of patients with inhalation injury between April 2011 and December 2016 except for cardiopulmonary arrest patients. We reviewed medical records to investigate patient background factors, bronchoscopic findings, and outcomes. Data are represented as median (interquartile range). Results: Patients with inhalation injury comprised 36 patients (age: 64.5 [55.0-71.8] years, burn index: 1 [0-6.9], prognostic burn index: 71 [56.7-81.0], of whom 18 underwent chest CT scan and bronchoscopy. The results show that patients with higher bronchoscopic gradation were likely to have thicker bronchial walls proximally (Grade 1: n=5, 1.55 [1.04-2.01] mm; Grade 2: n=4, 1.89 [1.40-3.31] mm; Grade 3: n=3, 4.39 [2.45-6.58] mm; and Grade 4: n=6, 3.77 [2.97-5.49] mm; P<0.01) and distally (Grade 1: n=5, 1.45 [1.41-2.10] mm; Grade 2: n=4, 2.06 [1.59-2.33] mm; Grade 3: n=3, 3.4 [2.45-3.92] mm; and Grade 4: n=6, 3.62 [2.79-4.07] mm; P<0.01). Conclusion: The initial CT scan may help to predict the severity of inhalation injury earlier than bronchoscopy.
