Venous Thrombosis Incidence in Burn Patients Preliminary Results of a Prospective Study

There are few prospective data on the incidence of deep venous thrombosis (DVT) in burn patients. In an on-going prospective study, hospitalized burn patients 18 years or older with an expected hospital length of stay more than 72 hours were imaged with baseline ve-nous duplex ultrasound of all extremities within the first 48 hours after admission and weekly until discharge. Patient demographics and clinical risk factors for DVT were as-sessed. At the time of submission, 40 patients met screening criteria, and 30 were enrolled. Ultrasound diagnosed seven patients with 11 acute DVT for an incidence of 23%. One pul-monary embolism was documented. DVT patients had a mean age of 49 23 years with an average TBSA burn of 15 4 % compared with those without thrombosis with a mean age of 44 17 years (P NS) and TBSA burn of 18 25 % (P NS). There were no statisti-cally significant differences for DVT patients in terms of age, number of central line days, hospital length of stay, or TBSA burned. Given the preliminary findings of this small study, we believe that all hospitalized burn patients are at risk for DVT. On-going investigation will be helpful in defining level of risk and improved prevention strategies for thromboem-bolic complications in burn patients. (J Burn Care Rehabil 2002;23:97–102) Deep venous thrombosis (DVT) and pulmonary em-bolism (PE) remain common complications in trau-matized patients, with the level of risk varying with the degree and site of injury.1,2 Despite the published “high risk ” of DVT for the multiply injured, many retrospective studies report incidences of thrombo-embolic complications in burn patients as low as 0.9% for symptomatic DVT3 and 0 to 0.4 % for symptom-atic PE.3–5 We recently reviewed our hospitalized burn patient registry for the diagnosis of symptomatic DVT and found an incidence of 2.4%.6 In addition to this finding, burn patient autopsies reveal the pres-ence of PE in as many as 30 % of burn deaths.7,8 These findings prompted us to determine prospectively the incidence of DVT in our burn population and to ex-amine which medical and burn-associated factors may be associated with thromboembolic complications