Venous thromboembolism in thermally injured patients: analysis of the National Burn Repository.

Currently, there is a paucity of information on the incidence of venous thromboembolism (VTE) in thermally injured patients. By using the National Burn Repository, the authors examined the incidence and risk factors for VTE after burn injury. The National Burn Repository was queried to identify adult burn patients treated between 1995 and 2007. Patients who died within 24 hours of admission, with length of stay less than 1 day, or who had nonthermal injuries were excluded. Bivariate statistics were generated to identify risk factors associated with VTE. Logistic regression was used to identify risk factors that were independently associated with VTE. The incidence of VTE in thermally injured patients was 0.6%. VTE incidence increased to 1.2% when patients required intensive care unit (ICU) admission or when patients had >10%TBSA burns. Patients with 40 to 59% TBSA burns were at highest risk for VTE (2.4%). TBSA burned, ICU days, and the number of operations were independently associated with increased VTE risk, when controlling for other risk factors. We created a predictive model for VTE, which included all variables that were known or could be derived at the time of admission. The combination of increased TBSA burned and need for ICU admission was strongly predictive (c-statistic = 0.82) of patients who developed VTE. At admission, the combination of increased TBSA burned and need for ICU admission predicts patients who develop VTE with high discrimination. Patients with these risk factors may benefit from early, aggressive VTE prophylaxis.