Dr Andrew Turner1, Dr Henry Shepherd1, Dr John Vandervord1, Dr Jeon Cha1
1Royal North Shore Hospital
Background: Burns patient are thought to have an increased risk of deep vein thrombosis (DVT) however the reported incidence ranges from 0.25% to 60%. The incidence and risk factors for DVT in the burns patient are yet to be definitively identified.
Objectives: To determine the incidence of DVT in burns patients at the Royal North Shore Hospital (RNSH) in NSW and to identify risk factors for the presence of DVT.
Methods: A five year retrospective study of all burns admissions to RNSH between 2012 and 2016 inclusive (n=977). Records were reviewed for diagnosed DVT during admission and potential risk factors, namely: age, sex, total body surface area of burn (TBSA), length of hospital stay, number of operations, length and presence of mechanical ventilation and ICU admission, length and location of central venous access and presence of pulmonary embolism.
Findings: 30 patients were diagnosed with DVT: an incidence of 3.07%. Patients with DVT were significantly older (mean:51.7 & 43.0; p=0.015), had a higher %TBSA (mean:22.4 & 8.25; p=0.002), longer hospital stay (mean:45.4 & 9.44 days; p<0.001), more operations (mean:4.10 & 1.31; p<0.001) and more days ventilated (mean:13.3 & 0.800; p=0.007) and in ICU (mean:19.1 &1.35; p=0.001) than patients without DVT. Lines were present or previously present within thrombosed veins for 11 of these patients. 5 patients were diagnosed with pulmonary embolism.
Conclusion: 3% of RNSH burns patients develop DVT. Presence of DVT is significantly associated with older age, %TBSA, more operations and longer time spent ventilated, in ICU and in hospital.
Andrew Turner is a current SRMO at Royal North Shore Hospital interested in research in patients with severe burns