Systematic review of the epidemiological characteristics of inhalation injury in burn patients in China

Objective To study the epidemiological characteristics of inhalation injury in burn patients in China. Methods The systematic review method was performed.Chinese Journal Full-text Database,Wanfang Database,andChineseBiomedical Literature Database were searched with the Chinese search terms of "吸入性损伤, 呼吸道烧伤, 喉烧伤", and PubMed and Embase were searched with the search terms of "burns, inhalation injury" to retrieve the collected retrospective studies on the epidemiological characteristics of inhalation injury in burn patients in China from the establishment of each database to January 2019. Data were extracted from the included articles, including the first author, study institution, study period, study subjects, number of burn patients, incidence of inhalation injury, and gender, age, causes of injury, mortality, and causes of death in patients with inhalation injury. Results A total of 24 articles were included in this study with the first authors being from multiple research institutions across the country. The articles reported single or multi-center epidemiological studies with statistics on the incidence of inhalation injury in burn patients or severe burn patients admitted to key burn treatment institutions in many provinces/cities in China from 1958 to 2016. The number of burn patients included was 103-64 320 cases in the studies, and the incidence of inhalation injury in hospitalized burn patients ranged from 4.89% to 11.28%, with no obvious trend. The incidence of inhalation injury in severe burn patients was still high, from 19.09% to 32.38% as most articles reported. The number of men with inhalation injury was larger than that of women, with a male-to-female ratio of 1.61 ∶1.00-4.95 ∶1.00; young and middle-aged people were the high-risk population, and flame burn was the main cause of injury. The mortality of patients with inhalation injury was 5.17%-58.67%, of which the mortality was 5.17%-24.75% since 2000, in accordance with reports from hospitals in various regions that the mortality in the later period decreased significantly compared with the previous period. The causes of death in patients with inhalation injury included upper respiratory tract obstruction, sepsis, respiratory failure, and severe pulmonary infection. Conclusions From 1958 to 2016, there is no obvious trend in the incidence of inhalation injury among burn patients in China; the incidence of inhalation injury is high in young and middle-aged males, and the main cause of inhalation injury is flame burn. The mortality of inhalation injury generally decreased since 2000 compared with the previous period.