Inhalation injury severity scoring system: A quantitative method

David L. Brown, Stephen B. Archer, David G Greenhalgh, Mark A. Washam, Laura E. James, Glenn D. Warden

Research output: Contribution to journalArticle

36 Scopus citations


Inhalation injury, a major contributor to burn-related mortality, has been difficult to quantify. A scoring system paralleling current adult respiratory distress syndrome systems has the potential to distinguish survivors from nonsurvivors. The utility of the PaO 2/FiO 2 (P/F) ratio in predicting injury severity was first examined. In a review of 120 patients with inhalation injury, those with P/F ratios greater than or equal to 300 after resuscitation were more likely to survive than those with ratios less than 300. The P/F ratio had no value when obtained before resuscitation. Next, a scoring system was developed to assist in comparing the severity of injury in ventilator-dependent patients with burns. Measurements were recorded prospectively in four categories: chest x-ray evaluation, P/F ratio, peak inspiratory pressure, and bronchoscopy. When comparing survivors (20) versus nonsurvivors (6), significant differences were found early (day 0, day 1, and week 1) for P/F ratio and overall severity score. Differences were seen later (week 1 and week 2) for chest x-ray evaluation and peak inspiratory pressure values. Because of low numbers the value of bronchoscopy could not be evaluated. The role of an inhalation injury severity scoring system for predicting survival should be examined in larger prospective trials.

Original languageEnglish (US)
Pages (from-to)552-557
Number of pages6
JournalJournal of Burn Care and Rehabilitation
Issue number6
StatePublished - Nov 1996
Externally publishedYes

ASJC Scopus subject areas

  • Rehabilitation
  • Surgery
  • Nursing(all)
  • Health Professions(all)
  • Emergency Medicine

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