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Pulmonary emboli in burned patients.
1Department of Surgery, University of Texas (Southwestern Medical School) Health Science Center, Dallas 75235.
The Journal of Trauma
|February 1, 1988
Summary
Pulmonary emboli (PE) are rare in burn patients, occurring in only 0.4% of adults. Routine heparin prophylaxis is not justified due to the low incidence and morbidity of PE in this population.
Area of Science:
- Medical research
- Burn patient care
- Thromboembolism
Background:
- Clinically significant pulmonary emboli (PE) and their prophylaxis are a concern in burn patient management.
- Understanding the true incidence of PE in acute burn admissions is crucial for guiding treatment strategies.
Purpose of the Study:
- To determine the incidence of clinically important pulmonary emboli (PE) in patients admitted with acute burns.
- To evaluate the risk factors and outcomes associated with PE in this patient cohort.
Main Methods:
- A retrospective review of 2,106 patients admitted with acute burns, including 1,439 adults.
- Clinical follow-up for evidence of thromboembolism was conducted.
- Analysis of patient demographics, burn characteristics, and risk factors for PE.
Main Results:
- No children experienced PE. Six adult patients (0.4%) developed PE, with no associated mortality.
- The mean burn size was 26.8%, mean age 35.1 years, and mean weight 90.8 kg.
- Patients with PE were not ICU patients and lacked lower-extremity IV lines; two experienced events post-discharge. Only two had significant risk factors (obesity, leg burns).
Conclusions:
- The low incidence of pulmonary emboli and resulting morbidity in burn patients does not support routine prophylactic heparinization for all individuals.
- Risk factor assessment may be more appropriate than universal prophylaxis.