Global evacuation of burn patients does not increase the incidence of venous thromboembolic complications.
BACKGROUND
Case-control studies have suggested that air travel may be a risk factor for the development of Venous Thromboembolism (VTE). Burned patients from the current war in Iraq and Afghanistan, are transported across three continents to our Burn Center with total ground and air transport time being approximately 24 hours spread over 3 days to 4 days. We hypothesized global evacuation results in increased VTE rates.


METHODS
Retrospective review of 1,107 consecutive patients admitted to our burn center from January 2003 to December 2005.


RESULTS
In the time period evaluated, no detectible differences were found in incidence of VTE between air-evacuated soldiers and those admitted to our facility from South Texas (1.31% vs. 0.83%, p = ns). The air-evacuated soldiers were younger (26 +/- 7 vs. 41 +/- 19, p < 0.0001) but had a higher incidence of inhalation injury (14.4% vs. 8.0%, p < 0.0001) and higher Injury Severity Score (10.9 +/- 13.0 vs. 6.5 +/- 9.2, p < 0.0001). No difference in average percent total body surface area involvement was found (15.8 +/- 19.4 vs. 15.5 +/- 18.4, p = ns). Overall, 11 of 1,107 (0.99%) burned patients developed VTE.


CONCLUSIONS
Prolonged global evacuation is not associated with increased risk of VTE.
Chung
Kevin K
KK
Clinical Division, U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA. kevin.chung@us.army.mil
Blackbourne
Lorne H
LH
Renz
Evan M
EM
Cancio
Leopoldo C
LC
Wang
Jingjing
J
Park
Myung S
MS
Horvath
Edward E
EE
Albrecht
Michael C
MC
White
Christopher E
CE
Wanek
Sandra M
SM
Barillo
David J
DJ
Wolf
Steven E
SE
Holcomb
John B
JB
D000328:Adult; D000346:Afghanistan; D002056:Burns / Q000150:complications / Q000628:therapy*; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D007493:Iraq; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014187:Transportation of Patients; D014481:United States; D054556:Venous Thromboembolism / Q000453:epidemiology*; D014857:Warfare