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; p = 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.
Violence against women is pervasive. An estimated 25% of Australian women (≥15 years) have experienced intimate partner violence. Recent cases of homicidal burn violence perpetrated against Australian women have shocked the nation. However, little evidence exists about the burden of burn violence against Australian women. This study describes and compares the frequency, sociodemographic profile, injuries, and outcomes of women admitted to Australian burn centers with burns from suspected violence with women with unintentional burns. Data were extracted from the Burns Registry of Australia and New Zealand for women (≥18 years) admitted to Australian burn centers between 2009 and 2022, with burns from suspected violence or unintentional burns. Sociodemographic profiles, injury, and in-hospital outcomes were compared. To further explore group differences, 155 women from each group were propensity score matched (one-to-one basis), with subsequent group comparisons made. Of 6262 women meeting inclusion criteria, few reported burns from suspected violence (2.5% vs 97.5%). Women with burns from suspected violence were younger (median 36 vs 43 years), greater proportions sustained flame burns (38.1% vs 25.3%) involving petrol (80.0% vs 38.0%), their injuries more likely involved their head (42.3% vs 16.4%), and a greater proportion died (4.5% vs 1.5%). Perpetrators were most often intimate partners. Our study contributes to emerging international literature demonstrating the confronting nature and consequences of burn violence against women. Building capacity among burn center teams to identify and respond to suspected burn violence will better protect Australian women and align with national plans to end violence against women.
Burn survivors can experience social participation challenges throughout their recovery. The aim of this study was to develop a novel Australian English translation of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, the Aus-LIBRE Profile. This study consisted of 3 stages: (1) translation of the LIBRE Profile from American to Australian English by Australian researchers/burns clinicians, (2) piloting and cognitive evaluation of the Aus-LIBRE Profile with burn survivors to assess the clarity and consistency of the interpretation of each individual item, and (3) review of the Aus-LIBRE Profile by colleagues who identify as Aboriginal Australians for cross-cultural validation. In stage 2, investigators administered the translated questionnaire to 20 Australian patients with burn injuries in the outpatient clinic (10 patients from Victoria and 10 patients from Western Australia). Face validity of the Aus-LIBRE Profile was tested in 20 burns survivors (11 females) ranging from 21 to 74 years (median age 43 years). The total body surface area burned ranged from 1% to 50% (median 10%). Twelve language changes were made based on the feedback from the burn clinicians/researchers, study participants, and colleagues who identify as Aboriginal Australians. Using a formal translation process, the Aus-LIBRE Profile was adapted for use in the Australian burn population. The Aus-LIBRE Profile will require psychometric validation and testing in the Australian patient with burns population before broader application of the scale.