Lincoln M Tracy1, Peter A Cameron1,2, Yvonne Singer1,3, Arul Earnest4,5, Fiona Wood6, Heather Cleland1,3, Belinda J Gabbe1,7. 1. School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia. 2. Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Melbourne, Victoria, 3004, Australia. 3. Victorian Adult Burns Service, Alfred Hospital, 55 Commercial Road, Melbourne, Victoria, 3004, Australia, Australia. 4. Registry Sciences Unit, Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia. 5. Biostatistics Unit, Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia. 6. Burn Injury Research Unit, University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia. 7. Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, Swansea, UK.
Abstract
BACKGROUND: Patients with burn injuries are considered to have an increased risk of venous thromboembolism (VTE). While untreated VTEs can be fatal, no studies have examined chemoprophylaxis effectiveness. This study aimed to quantify the variation in prevalence of VTE prophylaxis use in patients in Australian and New Zealand burns units and whether prophylaxis use is associated with in-hospital outcomes following burn injury. METHODS: Admission data for adult burns patients (aged ≥16 years) admitted between 1 July 2016 and 31 December 2018 were extracted from the Burns Registry of Australia and New Zealand. Mixed effects logistic regression modelling investigated whether VTE prophylaxis use was associated with the primary outcome of in-hospital mortality. RESULTS: There were 5066 admissions over the study period. Of these patients, 81% (n = 3799) with a valid response to the VTE prophylaxis data field received some form of VTE prophylaxis. Use of VTE prophylaxis ranged from 48.6% to 94.8% of patients between units. In-hospital death was recorded in <1% of patients (n = 33). After adjusting for confounders, receiving VTE prophylaxis was associated with a decrease in the adjusted odds of in-hospital mortality (adjusted odds ratio = 0.21; 95% CI, 0.07-0.63; p = 0.006). CONCLUSIONS: Variation in the use of VTE prophylaxis was observed between the units, and prophylaxis use was associated with a decrease in the odds of mortality. These findings provide an opportunity to engage with units to further explore differences in prophylaxis use and develop future best practice guidelines.
BACKGROUND: Patients with burn injuries are considered to have an increased risk of venous thromboembolism (VTE). While untreated VTEs can be fatal, no studies have examined chemoprophylaxis effectiveness. This study aimed to quantify the variation in prevalence of VTE prophylaxis use in patients in Australian and New Zealand burns units and whether prophylaxis use is associated with in-hospital outcomes following burn injury. METHODS: Admission data for adult burns patients (aged ≥16 years) admitted between 1 July 2016 and 31 December 2018 were extracted from the Burns Registry of Australia and New Zealand. Mixed effects logistic regression modelling investigated whether VTE prophylaxis use was associated with the primary outcome of in-hospital mortality. RESULTS: There were 5066 admissions over the study period. Of these patients, 81% (n = 3799) with a valid response to the VTE prophylaxis data field received some form of VTE prophylaxis. Use of VTE prophylaxis ranged from 48.6% to 94.8% of patients between units. In-hospital death was recorded in <1% of patients (n = 33). After adjusting for confounders, receiving VTE prophylaxis was associated with a decrease in the adjusted odds of in-hospital mortality (adjusted odds ratio = 0.21; 95% CI, 0.07-0.63; p = 0.006). CONCLUSIONS: Variation in the use of VTE prophylaxis was observed between the units, and prophylaxis use was associated with a decrease in the odds of mortality. These findings provide an opportunity to engage with units to further explore differences in prophylaxis use and develop future best practice guidelines.
Authors: Judith A McInnes; Heather J Cleland; Peter A Cameron; Anne Darton; Lincoln M Tracy; Fiona M Wood; Yvonne Singer; Belinda J Gabbe Journal: Burns Date: 2019-07-24 Impact factor: 2.744
Authors: Mark Oremus; Mark D Hanson; Richard Whitlock; Edward Young; Carolyn Archer; Arianna Dal Cin; Alok Gupta; Parminder Raina Journal: J Burn Care Res Date: 2007 Nov-Dec Impact factor: 1.845