Venous Thromboembolism Incidence, Risk Factors, and Prophylaxis in Burn Patients: A National Trauma Database Study

Abstract

Comprehensive studies on the incidence, risk factors, and prophylactic measures related to venous thromboembolism (VTE) are lacking in burn care. This study characterizes VTE risk and existing prevention measures to improve and inform overall patient care in the field of burn care on a national scale. The US National Trauma Data Bank was queried from 2007 to 2021 to identify burn-injured patients. Descriptive statistics and multivariate regression analyses were used to explore the association between demographic/clinical characteristics and VTE risk as well as compare various VTE chemoprophylaxis types. There were 326 614 burn-injured patients included for analysis; 5642 (1.7%) experienced a VTE event during their hospitalization. Patients with VTE were significantly older, had greater body mass indexes and % total body surface area, and were more likely to be male (P < .001). History of smoking, hypertension or myocardial infarction, and/or substance use disorder were significant predictors of VTE (P < .001). Patients who received low molecular weight heparin were less likely to have VTE compared to patients treated with heparin when controlling for other VTE risk factors (odds ratio [OR]: 0.564, 95% confidence interval [95% CI]: 0.523-0.607, P < .001). Longer time to VTE chemoprophylaxis (>6 h) initiation was significantly associated with VTE (OR = 1.04, 95% CI: 1.03-1.07, P < .001). This study sheds light on risk factors and chemoprophylaxis in VTE to help guide clinical practice when implementing prevention strategies in patients with burns. This knowledge can be leveraged to refine risk stratification models, inform evidence-based prevention strategies, and ultimately enhance the quality of care for patients with burns at risk of VTE.

Keywords: burn; heparin; prophylaxis; risk; venous thromboembolism.