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Global Evacuation of Burn Patients Does Not Increase the Incidence of Venous Thromboembolic Complications

Chung, Kevin K. MD; Blackbourne, Lorne H. MD; Renz, Evan M. MD; Cancio, Leopoldo C. MD; Wang, Jingjing MS; Park, Myung S. MD; Horvath, Edward E. DO; Albrecht, Michael C. MD; White, Christopher E. MD; Wanek, Sandra M. MD; Barillo, David J. MD; Wolf, Steven E. MD; Holcomb, John B. MD

The Journal of Trauma: Injury, Infection, and Critical Care: July 2008 - Volume 65 - Issue 1 - p 19-24
doi: 10.1097/TA.0b013e3181271b8a
Original Articles

Background: Case-control studies have suggested that air travel may be a risk factor for the development of Venous Thromboembolism (VTE). Burned patients from the current war in Iraq and Afghanistan, are transported across three continents to our Burn Center with total ground and air transport time being approximately 24 hours spread over 3 days to 4 days. We hypothesized global evacuation results in increased VTE rates.

Methods: Retrospective review of 1,107 consecutive patients admitted to our burn center from January 2003 to December 2005.

Results: In the time period evaluated, no detectible differences were found in incidence of VTE between air-evacuated soldiers and those admitted to our facility from South Texas (1.31% vs. 0.83%, p = ns). The air-evacuated soldiers were younger (26 ± 7 vs. 41 ± 19, p < 0.0001) but had a higher incidence of inhalation injury (14.4% vs. 8.0%, p < 0.0001) and higher Injury Severity Score (10.9 ± 13.0 vs. 6.5 ± 9.2, p < 0.0001). No difference in average percent total body surface area involvement was found (15.8 ± 19.4 vs. 15.5 ± 18.4, p = ns). Overall, 11 of 1,107 (0.99%) burned patients developed VTE.

Conclusion: Prolonged global evacuation is not associated with increased risk of VTE.

From the Clinical Division (K.K.C., L.H.B., E.M.R., L.C.C., M.S.P., E.E.H., M.C.A., C.E.W., S.M.W., D.J.B., S.E.W., J.B.H.) and the Research Division (J.W.), U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas.

Submitted for publication January 3, 2007.

Accepted for publication May 25, 2007.

Address for reprints: Kevin K. Chung, MD, 3400 Rawley E. Chambers Avenue, Fort Sam Houston, TX 78234; email:

© 2008 Lippincott Williams & Wilkins, Inc.