707 Is Central Venous Catheter the Main Culprit for Clinically Significant Venous Thromboembolism in Burn Patients

TL;DR

This study examines whether central venous catheters are the main cause of blood clots in burn patients, finding that all clots occurred at catheter sites despite preventive medication.

Contribution

The study identifies central venous catheters as the primary source of VTE in burn patients, despite chemoprophylaxis use.

Findings

All 7 VTE cases occurred at central venous catheter insertion sites.

VTE incidence was 1.7%, lower than non-burn patients with catheter-related VTE.

No significant correlation between VTE and burn size, age, or hospital stay.

Abstract

Venous thromboembolism (VTE) is a significant clinical problem for burn patients. The incidence of VTE has been reported as 0.25% to 47.1%. Known risk factors include large burn size, increasing age, male gender, active smoker or alcohol use, blood transfusion and surgeries. Central venous line (CVL) use is also a known risk factor for VTE. With all the known factors, we retrospectively analyzed our patients with VTE.

Retrospective chart review was performed on a single institution burn center in the calendar year of 2022. Pediatric patients were excluded. Following data were collected: age, burn size, mechanism, length of hospital stays, VTE diagnosis, VTE chemoprophylaxis, and central venous line days. VTE diagnosis was made using CT venogram or ultrasound. This project was a quality improvement initiative

There were 420 patients in the study period. Of all the admitted patients, there were 6 patients diagnosed with 7 VTE. One patient had 2 separate diagnoses of VTE at 2 distinct period and anatomical site. The incidence of VTE is 1.7%. Upon further chart review, all the VTE were at the site of central venous catheters. All the patients were on VTE chemoprophylaxis. The correlation between burn size, age, length of hospital stay and VTE was not significant.

Risk of VTE is high in burn patients due to the correlation with the Virchow’s Triad. All the patients admitted to the burn unit are placed on chemoprophylaxis unless contraindicated. The 7 patients diagnosed with VTE were on chemoprophylaxis. All the VTE were at the site of central venous catheter insertion sites, which is a known complication of catheters. The incident of 1.7% is on par with VTE incidents of burn patients, but much less than VTE caused by central venous catheters in non-burn patients. Large multicenter data collection is needed to validate this finding.

Understanding the Importance of Chemoprophylaxis in Burn patients in comparison to Non-Burn Patients in Relation to Central Venous Catheter Associated VTE