• Ning Li, Jianglin Tan, Xue Feng, Maojun Li, Li Qin, and Junyi Zhou.
• Institute of Burn Research, Southwest Hospital, the Army Medical University (the Third Military Medical University), Chongqing 400038, China; State Key Laboratory of Trauma, Burn and Combined Injury, China. Electronic address: 276806@tmmu.edu.cn.
• Burns. 2025 Jan 21; 51 (3): 107398107398.

ObjectiveTo investigate coagulation disorders and thrombotic complications in the early stage after burn, and to evaluate the predictive reliability of D-dimer for deep vein thrombosis (DVT) diagnosis in major burn patients.MethodsThis retrospective study was performed in the Department of Burns, Southwest Hospital, and included 288 adult major burn patients (≥40 % TBSA) without prophylactic anticoagulant therapy. All patients received routine screening assays of coagulation indicators and Doppler ultrasound scan (DUS) during the 28 days post-burn regardless of the clinical symptoms of DVT.ResultsCoagulation abnormalities were commonly observed during the 28 days post-burn. There were 24 patients (8.33 %) diagnosed with DVT based on DUS on a median of 23 days after burn. Older age (OR=1.47) and increased insertions of central venous catheter (OR=1.67) were identified as independent risk factors for DVT. Serum D-dimer levels were elevated in 97.6 % (281/288) of patients in the first week post-burn. Patients identified with DVT had significantly higher serum D-dimer levels on the 3rd and 7th days post-burn. The D-dimer level on the 7th post-burn day showed a moderate predictive value for DVT by ROC analysis (AUC=0.711). The optimal threshold was 2.25 mg/L, with a sensitivity of 0.818 and a specificity of 0.566 at this threshold.ConclusionEarly coagulation disorder can occur and last for over 28 days after major burn injury. The serum D-dimer level on the 7th post-burn day may be used as a risk factor to identify the individuals with high-risk of DVT among major burn patients.Copyright © 2025 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.

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