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Venous thrombosis after long-haul flights.
Arch Intern Med. 2003 Dec 8-22; 163(22):2759-64.AI

Abstract

BACKGROUND

The risk for venous thromboembolism after long-haul flights represents a controversial issue. The aim of our study was to assess the incidence of venous thrombosis associated with long-haul flights in a prospective, controlled cohort study.

METHODS

We included 964 passengers returning from long-haul flights (flight duration, > or =8 hours) and 1213 nontraveling control subjects. We excluded participants who were being treated with anticoagulant drugs or who used compression stockings. Main outcome measures were the incidence of ultrasonographically diagnosed thrombosis in the calf muscle and deep veins, symptomatic pulmonary embolism, and death.

RESULTS

We diagnosed venous thrombotic events in 27 passengers (2.8%) and 12 controls (1.0%) (risk ratio [RR], 2.83; 95% confidence interval [CI], 1.46-5.49). Of these, 20 passengers (2.1%) and 10 controls (0.8%) presented with isolated calf muscle venous thrombosis (RR, 2.52; 95% CI, 1.20-5.26), whereas 7 passengers (0.7%) and 2 controls (0.2%) presented with deep venous thrombosis (RR, 4.40; 95% CI, 1.04-18.62). Symptomatic pulmonary embolism was diagnosed in 1 passenger with deep venous thrombosis (P =.44). All of these individuals had normal findings at baseline ultrasonography. Passengers with isolated calf muscle venous thrombosis or deep venous thrombosis had at least 1 risk factor for venous thrombosis (>45 years of age or elevated body mass index in 21 of 27 passengers). The follow-up after 4 weeks revealed no further venous thromboembolic event.

CONCLUSIONS

Long-haul flights of 8 hours and longer double the risk for isolated calf muscle venous thrombosis. This translates into an increased risk for deep venous thrombosis as well. In our study, flight-associated thrombosis occurred exclusively in passengers with well-established risk factors for venous thrombosis.

Authors+Show Affiliations

Division of Vascular Medicine, Department of Internal Medicine III, University of Dresden Medical School, Germany. tho_schwartz@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14662630

Citation

Schwarz, Thomas, et al. "Venous Thrombosis After Long-haul Flights." Archives of Internal Medicine, vol. 163, no. 22, 2003, pp. 2759-64.
Schwarz T, Siegert G, Oettler W, et al. Venous thrombosis after long-haul flights. Arch Intern Med. 2003;163(22):2759-64.
Schwarz, T., Siegert, G., Oettler, W., Halbritter, K., Beyer, J., Frommhold, R., Gehrisch, S., Lenz, F., Kuhlisch, E., Schroeder, H. E., & Schellong, S. M. (2003). Venous thrombosis after long-haul flights. Archives of Internal Medicine, 163(22), 2759-64.
Schwarz T, et al. Venous Thrombosis After Long-haul Flights. Arch Intern Med. 2003 Dec 8-22;163(22):2759-64. PubMed PMID: 14662630.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Venous thrombosis after long-haul flights. AU - Schwarz,Thomas, AU - Siegert,Gabriele, AU - Oettler,Wolfram, AU - Halbritter,Kai, AU - Beyer,Jan, AU - Frommhold,Roswitha, AU - Gehrisch,Siegmund, AU - Lenz,Florian, AU - Kuhlisch,Eberhard, AU - Schroeder,Hans-Egbert, AU - Schellong,Sebastian M, PY - 2003/12/10/pubmed PY - 2004/1/8/medline PY - 2003/12/10/entrez SP - 2759 EP - 64 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 163 IS - 22 N2 - BACKGROUND: The risk for venous thromboembolism after long-haul flights represents a controversial issue. The aim of our study was to assess the incidence of venous thrombosis associated with long-haul flights in a prospective, controlled cohort study. METHODS: We included 964 passengers returning from long-haul flights (flight duration, > or =8 hours) and 1213 nontraveling control subjects. We excluded participants who were being treated with anticoagulant drugs or who used compression stockings. Main outcome measures were the incidence of ultrasonographically diagnosed thrombosis in the calf muscle and deep veins, symptomatic pulmonary embolism, and death. RESULTS: We diagnosed venous thrombotic events in 27 passengers (2.8%) and 12 controls (1.0%) (risk ratio [RR], 2.83; 95% confidence interval [CI], 1.46-5.49). Of these, 20 passengers (2.1%) and 10 controls (0.8%) presented with isolated calf muscle venous thrombosis (RR, 2.52; 95% CI, 1.20-5.26), whereas 7 passengers (0.7%) and 2 controls (0.2%) presented with deep venous thrombosis (RR, 4.40; 95% CI, 1.04-18.62). Symptomatic pulmonary embolism was diagnosed in 1 passenger with deep venous thrombosis (P =.44). All of these individuals had normal findings at baseline ultrasonography. Passengers with isolated calf muscle venous thrombosis or deep venous thrombosis had at least 1 risk factor for venous thrombosis (>45 years of age or elevated body mass index in 21 of 27 passengers). The follow-up after 4 weeks revealed no further venous thromboembolic event. CONCLUSIONS: Long-haul flights of 8 hours and longer double the risk for isolated calf muscle venous thrombosis. This translates into an increased risk for deep venous thrombosis as well. In our study, flight-associated thrombosis occurred exclusively in passengers with well-established risk factors for venous thrombosis. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/14662630/Venous_thrombosis_after_long_haul_flights_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/163/pg/2759 DB - PRIME DP - Unbound Medicine ER -