Analysis of deep vein thrombosis in burn patients.
OBJECTIVE
Deep vein thrombosis (DVT) represents a major cause of morbidity in surgical patients. Controversial reports exist on the incidence of DVT in burn patients. We report our experience over a 10-year period.


METHODS
Patients admitted to our Burn Unit over the period 1991-2001 and diagnosed with DVT were identified. Their records were retrospectively reviewed for demographic factors, extent and severity of burn injury and outcome.


RESULTS
A total of 4102 patients were admitted to the WPH Burn unit during the study period. All patients received routine subcutaneous heparin prophylaxis. Ten patients were diagnosed with DVT (0.25%). Compared to our total burn population, these patients were older (mean age 47 +/- 22.7 years versus 35 +/- 22 years P = 0.14) and had more extensive burns (mean total body surface area (TBSA) 34.7 +/- 25.3% versus 12 +/- 15.7% P = 0.02). Two patients developed non-fatal pulmonary embolism (PE). There were three deaths, none due to thromboembolic disease. There were no complications from the routine administration of subcutaneous heparin.


CONCLUSIONS
The incidence of DVT in our study is much less than the incidence reported in other critically ill patients and less than that of most reports on burn patients. In our experience, routine heparin prophylaxis is effective for the prevention of DVT in burn patients.
Fecher
A M
AM
Department of Surgery, Burn Trauma Unit, The Western Pennsylvania Hospital, Temple University School of Medicine, Clinical Campus, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA. afecher@wpahs.org
O'Mara
M S
MS
Goldfarb
I W
IW
Slater
H
H
Garvin
R
R
Birdas
T J
TJ
Caushaj
P F
PF
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D001830:Body Surface Area; D002056:Burns / Q000150:complications*; D002648:Child; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000209:etiology* / Q000517:prevention & control
D000925:Anticoagulants; D006493:Heparin