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Published on: February 23, 2024
Adult Burn Survivors Face Elevated Long-Term Risk of Major Adverse Cardiovascular Events, Venous Thromboembolism, and
Yu-Hsiang Lin1, Yu-Ching Wang1, Tai-Li Chen1
1Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Objective:
Burn injuries affect millions globally, with increasing survival rates due to advances in acute care. However, long-term cardiovascular outcomes including major adverse cardiovascular events (MACE), venous thromboembolism (VTE), and mortality in burn survivors remain under-investigated.
Approach:
We conducted a retrospective propensity score-matched cohort study using the TriNetX US Collaborative Network. Individuals aged 18 years or older who had an emergency department visit or hospitalization with a diagnosis of burn injuries occurring between January 1, 2014, and January 1, 2019, were identified and matched 1:1 to nonburn controls who were selected based on similar demographics, comorbidities, and medications. The primary outcomes were the hazard ratios (HRs) and absolute risk differences (ARDs) of MACE, VTE, and mortality occurring between 3 months and 5 years after the index date. Secondary cardiovascular and thromboembolic endpoints included the HRs and ARDs of coronary artery disease (CAD), cerebrovascular disease (CVD), pulmonary embolism (PE), and deep vein thrombosis (DVT).
Results:
A total of 71,426 propensity score-matched pairs of burn survivors and nonburn controls were included. Burn survivors had significantly elevated risks of MACE (HR 1.95, 95% confidence intervals [CI] 1.84-2.07; ARD 0.9%), VTE (HR 1.99, 95% CI 1.80-2.19; ARD 0.4%), and all-cause mortality (HR 2.29, 95% CI 2.10-2.49; ARD 0.7%) compared with controls. Increased risks were also observed for CAD (HR 1.85, 95% CI 1.72-1.98; ARD 0.5%), CVD (HR 2.05, 95% CI 1.88-2.24; ARD 0.5%), PE (HR 2.09, 95% CI 1.77-2.47; ARD 0.1%), and DVT (HR 1.96, 95% CI 1.69-2.27; ARD 0.1%).
Innovation:
We demonstrate that burn injury is associated with sustained long-term cardiovascular and thromboembolic risks up to 5 years after injury.
Conclusions:
These findings establish burn injury as a chronic condition, requiring routine cardiovascular screening and targeted prevention in long-term care.
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