National Estimates and Outcomes for Supplemental Home Oxygen Therapy Injuries-A Burn Care Quality Platform Analysis

The incidence of admissions for burn and inhalation injuries related to home oxygen therapy remains poorly defined in the U.S. We analyzed the American Burn Association's Burn Care Quality Platform (BCQP) database (2013-2022) to generate national estimates of supplemental home oxygen therapy-related injuries and outcomes. Text string extraction identified cases using multiple search permutations related to home oxygen use. Patient demographics, injury characteristics, and inpatient outcomes were described. Logistic regression assessed predictors of oxygen therapy injuries, and Poisson regression estimated adjusted incidence rates. Of 207 364 burn admissions, 79 114 (28%) contained injury descriptions, with 3.0% (2360 cases) attributed to home oxygen therapy. These patients had a median age of 65 years (IQR: 59-71), mean total body surface area (TBSA) of 4.1%, were predominantly male (62.6%) and white (79.0%). Medicare was the most common payer (57.7%). Inhalation injury was present in 11.4%, mean length of stay was 8 days, and inpatient mortality was 6.1%. Smoking was the leading ignition source (63%), followed by cooking/stove (4%), while 22% had no identified cause. The adjusted incidence rate of supplemental home oxygen injuries was 3.6% (95% CI, 2.7%-2.9%; P < 0.001), with a significant annual increase (incidence rate ratio: 1.03; 95% CI, 1.02-1.04). Oxygen therapy-related injuries account for 1088 (95% CI, 1065-1113) burn admissions per year in the U.S. Despite smaller TBSA burns, mortality was twice the national average for burn patients, and for survivors, the odds of discharge home were 15% less likely. Targeted prevention strategies are needed to mitigate this growing public health problem.