Remote delivery of thrombolytics prior to transfer to a regional burn center for tissue salvage in frostbite: A single center experience of 199 patients.
J Burn Care Res
washington; olympia; psph
While much has been published on efficacy and safety of systemic thrombolytics in the treatment of acute frostbite, there has been limited investigation into administration outside a tertiary care setting. Here, we present a single-center experience with remote initiation of intravenous tissue plasminogen activator (tPA) at referring hospitals prior to transfer to a regional burn center. A modified Hennepin Quantification Score based on tissue involvement was used to determine eligibility for tPA and to quantify severity of amputation. This is a retrospective review of patients with acute frostbite of the digits admitted to a single verified burn center over a five-year period. Of 199 patient admissions, 40 received tPA remotely pre-transfer, 32 received tPA on admission to our institution, and 127 patients did not qualify for tPA therapy according to the protocol. Comparing patients who required any amputation (n=99, 49.7%) to those who did not, patients who received remote tPA had lower odds of any amputation compared to both those receiving tPA at our institution (OR 0.19, 95% CI 0.05 - 0.65, p=0.01) and the group receiving no tPA (OR 0.14, 95% CI 0.05 - 0.40, p
Carmichael, Heather; Michel, Samuel; Smith, Tyler M; Duffy, Patrick S; Wiktor, Arek J; and Lambert Wagner, Anne, "Remote delivery of thrombolytics prior to transfer to a regional burn center for tissue salvage in frostbite: A single center experience of 199 patients." (2021). Articles, Abstracts, and Reports. 4531.