Abbreviated_Injury_Score_for_Inhalation_Injury v.1
The abbreviated Injury Score (AIS) for Inhalation Injury classifies inhalation injury severity based on bronchoscopic findings. The AIS assigns a grade for each bronchoscopic findings: Features Grade Description No carbonaceous deposits, erythema, edema, bronchorrhea, or obstruction 0 No injury Minor or patchy areas of erythema, carbonaceous deposits, bronchorrhea, or bronchial obstruction present 1 Mild injury Moderate erythema, carbonaceous deposits, bronchorrhea, or bronchial obstruction present 2 Moderate injury Severe inflammation with friability, copious carbonaceous deposits, bronchorrhea, or obstruction present 3 Severe injury Mucosal sloughing, necrosis, or endoluminal obstruction present 4 Massive injury The different grades can be interpreted as: Grade In-hospital Survival (From Endorf and Gamelli) 0-1 84% 2-4 57%
Classifies inhalation injury severity based on bronchoscopic findings. Using the observation archetype an evaluation is made to grade the In-hospital Survival percentage of either 84% or 57%.
Use in adult patients with suspected inhalation injury undergoing flexible bronchoscopy. Why Use: There is currently no universal consensus exists on grading for inhalation injury hence the AIS has been widely utilized as the predominant bronchoscopic inhalation injury severity score in the literature. Of note, a multicenter prospective cohort study by the American Burn Association is currently underway to develop and validate a scoring system for inhalation injury based on clinical, radiographic, bronchoscopic, and biochemical parameters.
Note that: Some studies have found a non-statistically significant trend towards worse outcomes with higher AIS. AIS severity has not been consistently associated with mortality (Sheridan 2016). Cannot reliably predict need for high fluid resuscitation requirements. A typical flexible bronchoscope is on average 5 mm in diameter. Hence, bronchoscopy can only identify proximal airway changes and not the narrower distal and peripheral airway changes. Thus, bronchoscopic findings cannot be fully relied upon to accurately reflect the overall severity of airway inhalation injury.
Endorf FW, Gamelli RL. Inhalation injury, pulmonary perturbations, and fluid resuscitation. J Burn Care Res. 2007;28(1):80-3. Validation: Albright JM, Davis CS, Bird MD, et al. The acute pulmonary inflammatory response to the graded severity of smoke inhalation injury. Crit Care Med. 2012;40(4):1113-21. Mosier MJ, Pham TN, Park DR, Simmons J, Klein MB, Gibran NS. Predictive value of bronchoscopy in assessing the severity of inhalation injury. J Burn Care Res. 2012;33(1):65-73.
OBSERVATION.abbreviated_injury_score_for_inhalation_injury.v0, EVALUATION.abbreviated_injury_score_for_inhalation_injury.v0
