Model to predict life-threatening respiratory diseases in burn patients

Researchers have devised a model to predict burn patients who are most likely to develop life-threatening acute respiratory distress syndrome (ARDS).

The first-ever prediction model include three factors: the extent of the patient's inhalation injury, the percentage of the patient's body that was burned and whether the patient had high levels of a blood clotting protein called von Willebrand factor.

"The three-pronged model could be used to better identify at-risk patients for both the study and prevention of ARDS in patients with burn injury," wrote Dr. Afshar and colleagues.

ARDS is a form of respiratory failure caused by inflammation and the inability to exchange oxygen appropriately. Patients typically are put on ventilators, and many don't survive.

It usually occurs in patients who already are critically ill from predisposing conditions such as sepsis, pneumonia, burns, inhalation injury, traumatic or injuries. Burn injuries, especially those involving inhalation injuries, have the highest incidence of ARDS among all predisposing conditions.

In developing their prediction model, researchers examined clinical characteristics including burn and inhalation injury, alcohol misuse and current tobacco use; other health problems including diabetes, congestive heart failure, heart disease and chronic obstructive pulmonary disease (COPD); and five protein biomarkers found in plasma (the colorless fluid part of blood).

Among multiple prediction models examined, a model consisting of inhalation injury, the von Willebrand factor biomarker and the per cent of body burned did the best job of predicting which patients were most likely to develop ARDS.

Dr. Afshar and colleagues wrote that once the model is validated by other studies, it could guide clinical trials designed to prevent ARDS and identify burn patients who are at risk for ARDS.

The full findings are present in the journal- Annals of Surgery.