Thermally Injured Patients are at Significant Risk for Thromboembolic Complications
Abstract
Background: The incidence of thromboembolic complications such as deep vein thrombosis (DVT) and pulmonary embolism (PE) in thermally injured patients is considered sufficiently uncommon that routine prophylactic measures are not warranted. Nevertheless, the incidence of DVT/PE may be increasing. Methods: The records of 1,300 patients admitted to our unit from January 1990 to June 1995 were reviewed. Results: Twenty-three patients developed a clinically significant DVT, eight patients developed a PE, and two patients developed both a DVT and a PE, for an overall DVT/PE incidence of 2.9%. Four of 10 PEs were felt to be fatal. The DVT/PE patients were older (mean age, 42.6 vs. 28.7; p less than 0.001) and had larger burns (37% vs. 18%, p less than 0.001) than patients without evidence of DVT/PE. Body weight appeared to also influence DVT/PE rates, with obese patients ( greater than 30% over ideal body weight) having a higher incidence than patients with low or normal body weight (7.2 vs. 2.7%, p less than 0.015). Age and total body surface area (TBSA) burn had a synergistic effect on DVT/PE risk, with the sum of age and TBSA burn exerting the strongest independent effect when discriminant function analysis was performed (p less than 0.001). Conclusion: One can identify a population at increased risk of DVT/PE on the basis of the sum of age and TBSA burn, but prospective screening trials that assess all risk factors for DVT/PE should be performed before routine prophylaxis is used in thermally injured patients.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 01, 2001
- Accession Number
- ADA628368
Entities
People
- Bryan Jordan
- Cleon W. Goodwin
- David Harrington
- David W. Mozingo
- Leopoldo Cancio
- Patti Bird
Organizations
- United States Army Institute of Surgical Research