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Smoking on Home Oxygen Therapy: Characteristics of COPD Patients Transferred Intubated to a Burn Center
*Salam Al Kassis1, *Alisa Savetamal2, Nabil Atweh2, *Roselle E Crombie2, *Tawnya Hansen2, *Amanda Najjar3, *Stephen Chiu1, *Craig Moores1, *Tabitha Ku2, *Deborah Chen2, John T Schulz2
1Yale New Haven Hospital, New Haven, CT;2Bridgeport Hospital, Bridgeport, CT;3New york University, New york, NY
Objective: Do patients injured while smoking on home oxygen therapy (HOT) fare worse than those suffering equivalent burns and inhalation injury via other mechanisms?
Design: Case series
Setting: Inpatient burn center
Patients: Between 1/2006 and 12/2012, 109 burn patients were transferred to our center intubated. Their records were retrospectively analyzed. Patients’ demographics, comorbidities, total body surface area burned (TBSA), associated trauma, mechanism of injury, LOS, and time to extubatioin (TTE) were reviewed.
Main Outcome Measure: TTE, LOS, cost
Results:Fourteen out of 109 patients were injured while smoking on HOT (15.26 %). All 14 had COPD. They ranged in age from 53 to 77 years (mean 63 years), were predominantly male (10 of 14), and averaged 4% TBSA burn (0% to 10 %). The charges for the 14 admissions totaled $1,097,860 ($8003 to $284,835; mean $78,418 /admission). Average TTE was 5.7 + 10.2 days and Average LOS was 11.4 + 15.2 days. The 14 patients with injury secondary to smoking on HOT were age and TBSA matched to 14 controls (equivalent injury, no HOT). No significant differences in the average TTE, average LOS, average admission cost, or clinical signs of inhalation injury (i.e. soot and edema in the pharynx) were noted between the groups.
Conclusions: Injury secondary to smoking on HOT is a perennial problem and guidelines for prescribing HOT for smokers should be reassessed. Despite underlying lung disease, these patients on average do as well as patients without COPD who sustain similar injuries.
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