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Antithrombin deficiency and its relationship to severe burns
M Niedermayr1, W Schramm, L Kamolz
1Department of Anesthesiology and Intensive Care, Medical University of Vienna, 18-20 Waehringer Guertel, A-1090 Vienna, Austria.
Burns : Journal of the International Society for Burn Injuries
|November 23, 2006
Summary
Antithrombin (AT) deficiency is common in severe burn patients, increasing with larger burn surface area and inhalation injury. This deficiency independently predicts longer hospital stays and higher mortality rates.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Trauma Surgery
Background:
- Antithrombin (AT) is a key endogenous anticoagulant with anti-inflammatory effects.
- Severe burns can disrupt physiological processes, potentially affecting AT levels.
- Understanding AT deficiency incidence and impact in burn patients is crucial for optimizing care.
Purpose of the Study:
- To determine the incidence of Antithrombin deficiency in severe burn patients.
- To investigate the correlation between Antithrombin deficiency and burn severity indices, length of hospital stay (LOS), and mortality.
- To identify predictors of Antithrombin deficiency in this patient population.
Main Methods:
- Prospective data collection on 201 severe burn patients receiving human plasma-derived AT concentrate.
- Measurement of AT deficiency through the mean administered AT concentrate dose.
- Multiple regression analysis to assess the relationship between AT deficiency and variables like TBSA, inhalation injury (INHAL), age, gender, full-thickness burn (FTB), LOS, and mortality.
Main Results:
- 54% of patients developed Antithrombin deficiency, peaking in the first 5 days post-injury.
- Increased Total Body Surface Area burned (TBSA) and Inhalation Injury (INHAL) significantly correlated with higher risk of AT deficiency (p<0.0001 and p=0.037, respectively).
- Antithrombin deficiency was an independent predictor of increased LOS (p=0.036) and mortality (p=0.003).
Conclusions:
- Antithrombin deficiency is a frequent complication following severe burns.
- The development of AT deficiency is significantly associated with burn severity (TBSA and INHAL).
- AT deficiency independently contributes to prolonged hospital stays and increased mortality in burn patients.
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