Ben Khalifa H, Mokline A, Fraj H, Zarrouk S, Eljemi I, Gasri B, Ben Saad M, Messadi A A
Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunisie.
Service de Réanimation des Brûlés, Centre de Traumatologie et des Grands Brûlés, Tunis, Tunisie.
Ann Burns Fire Disasters. 2024 Sep 30;37(3):233-237. eCollection 2024 Sep.
Venous thromboembolic disease (VTE) in burn patients is an under-diagnosed and potentially serious complication. Its incidence varies according to studies performed. This retrospective and descriptive study conducted in an intensive burn care department in Tunisia over a period of 22 months (January 1, 2021 to October 30, 2022) included 24 patients who presented a thromboembolic complication among a total of 785 admissions (incidence of 3%): pulmonary embolism in 15 cases and deep venous thrombosis (DVT) in 9 cases. The mean age of the patients was 43.8 years, with a male:female sex ratio of 2:1. Two thirds of patients (n=17) had a pathological history: hypertension (n=3); diabetes (n=2) and neoplasia (n=2). Three patients were obese. The average TBSA was 29%. Burns involved lower limbs in 19 patients (79%). The mean time to onset of VTE was 27.8 days. Acute dyspnea was present in 1/2 of cases and tachycardia in 1/3 of cases. The association hypoxia-hypocapnia was found in 5 patients. The diagnosis was confirmed by: thoracic angioscan (n=14), pulmonary scintigraphy (n=1), venous Doppler ultrasound of the lower limbs (n=2) and phleboscan of lower limbs (n=7). Factors correlated with thromboembolic risk in our study were: TBSA 20% - 39% (p=0,029; RR=4), with lower limb involvement (p=0,068), catheterization duration ≥7 days (p=0,048; RR=3) and number of catheters >1 (p=0,01; RR=3). The outcome was favorable in 13 patients and fatal in 11 patients.
烧伤患者的静脉血栓栓塞性疾病(VTE)是一种诊断不足且可能严重的并发症。其发病率因所开展的研究而异。这项在突尼斯一家重症烧伤护理科进行的回顾性描述性研究,历时22个月(2021年1月1日至2022年10月30日),纳入了785例住院患者中出现血栓栓塞并发症的24例患者(发病率为3%):15例发生肺栓塞,9例发生深静脉血栓形成(DVT)。患者的平均年龄为43.8岁,男女比例为2:1。三分之二的患者(n = 17)有病史:高血压(n = 3);糖尿病(n = 2)和肿瘤(n = 2)。3例患者肥胖。平均烧伤总面积为29%。19例患者(79%)的烧伤累及下肢。VTE发病的平均时间为27.8天。半数病例出现急性呼吸困难,三分之一病例出现心动过速。5例患者存在低氧血症 - 低碳酸血症。诊断通过以下方式得以证实:胸部血管扫描(n = 14)、肺闪烁扫描(n = 1)、下肢静脉多普勒超声(n = 2)和下肢静脉造影(n = 7)。在我们的研究中,与血栓栓塞风险相关的因素有:烧伤总面积20% - 39%(p = 0.029;相对危险度 = 4)、累及下肢(p = 0.068)、置管时间≥7天(p = 0.048;相对危险度 = 3)以及导管数量>1(p = 0.01;相对危险度 = 3)。13例患者预后良好,11例患者死亡。