Venous thromboembolism in burn patients is not prevented by chemoprophylaxis

Abstract

Background: Venous thromboembolisms (VTE) including deep venous thrombosis and pulmonary embolism are serious complications following burn trauma. There are inconsistencies in the literature regarding thromboembolic prevention strategies and data suggests that complications occur despite chemoprophylaxis.

Objective: To determine the prevalence of deep venous thromboembolism and pulmonary embolism in burn patients who are actively being treated with VTE prophylaxis and to determine factors that help predict which anti-coagulated patients are at risk for VTE and may benefit from further treatment.

Materials and methods: Retrospective analysis of burn data registry and patient Charts 1980-2012.

Results: Out of 1549 burn patients in the registry fifty patients (3.2%) had a VTE but charts were only available for 26 of these for further analysis. Of these, 12 patients (46%) had a VTE while on chemoprophylaxis and 14 (54%) without chemoprophylaxis. There were no differences between groups, but 90% of DVT complications occurred to Caucasian patients and none to Asians. The VTE group had significantly higher rate of inhalation injury, higher TBSA, longer hospital stay and ICU stay than matched controls.

Conclusions: Chemoprophylaxis does not prevent VTEs. Burn severity predisposes to venous thromboembolic complications.