Tracy Lincoln M, Cameron Peter A, Singer Yvonne, Earnest Arul, Wood Fiona, Cleland Heather, Gabbe Belinda J
School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Melbourne, Victoria, 3004, Australia.
Burns Trauma. 2021 Feb 11;9:tkaa044. doi: 10.1093/burnst/tkaa044. eCollection 2021 Jan.
Patients with burn injuries are considered to have an increased risk of venous thromboembolism (VTE). While untreated VTEs can be fatal, no studies have examined chemoprophylaxis effectiveness. This study aimed to quantify the variation in prevalence of VTE prophylaxis use in patients in Australian and New Zealand burns units and whether prophylaxis use is associated with in-hospital outcomes following burn injury.
Admission data for adult burns patients (aged ≥16 years) admitted between 1 July 2016 and 31 December 2018 were extracted from the Burns Registry of Australia and New Zealand. Mixed effects logistic regression modelling investigated whether VTE prophylaxis use was associated with the primary outcome of in-hospital mortality.
There were 5066 admissions over the study period. Of these patients, 81% (n = 3799) with a valid response to the VTE prophylaxis data field received some form of VTE prophylaxis. Use of VTE prophylaxis ranged from 48.6% to 94.8% of patients between units. In-hospital death was recorded in <1% of patients (n = 33). After adjusting for confounders, receiving VTE prophylaxis was associated with a decrease in the adjusted odds of in-hospital mortality (adjusted odds ratio = 0.21; 95% CI, 0.07-0.63; = 0.006).
Variation in the use of VTE prophylaxis was observed between the units, and prophylaxis use was associated with a decrease in the odds of mortality. These findings provide an opportunity to engage with units to further explore differences in prophylaxis use and develop future best practice guidelines.
烧伤患者被认为静脉血栓栓塞（VTE）风险增加。未经治疗的VTE可能致命，但尚无研究考察化学预防的有效性。本研究旨在量化澳大利亚和新西兰烧伤病房患者VTE预防措施使用情况的差异，以及预防措施的使用与烧伤后住院结局是否相关。
从澳大利亚和新西兰烧伤登记处提取2016年7月1日至2018年12月31日期间收治的成年烧伤患者（年龄≥16岁）的入院数据。混合效应逻辑回归模型研究VTE预防措施的使用是否与住院死亡率这一主要结局相关。
研究期间共有5066例入院病例。其中，对VTE预防数据字段有有效回复的患者中，81%（n = 3799）接受了某种形式的VTE预防。各病房VTE预防措施的使用率在48.6%至94.8%之间。<1%的患者（n = 33）记录有住院死亡。在对混杂因素进行调整后，接受VTE预防与住院死亡率调整后的比值降低相关（调整后的比值比 = 0.21；95%置信区间，0.07 - 0.63；P = 0.006）。
各病房在VTE预防措施的使用上存在差异，预防措施的使用与死亡几率降低相关。这些发现为与各病房合作进一步探讨预防措施使用上的差异以及制定未来最佳实践指南提供了契机。
