Travel as a Risk Factor for Venous Thromboembolic Disease

Ferrari, Émile; Chevallier, Thierry; Chapelier, Alexis; Baudouy, Marcel

doi:10.1378/chest.115.2.440

Cited by 253 publications

(192 citation statements)

References 17 publications

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“…In 1954 Homans reported a case of DVT that occurred in a physician after a 14-h flight, thereby associating VTE and longterm immobility from confined seating with air travel [2]. Studies have shown that asymptomatic lower limb DVT may arise in up to 10% of long-distance travelers depending on patient baseline risk of VTE [3,4], and that 4-20% of patients presenting with VTE have traveled within a few weeks prior to the event [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

Hitos

Cannon²,

Cannon³

et al. 2007

Journal of Thrombosis and Haemostasis

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To cite this article: Hitos K, Cannon M, Cannon S, Garth S, Fletcher JP. Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel-related deep vein thrombosis. J Thromb Haemost 2007; 5: 1890-5.Summary. Background: Venous stasis is an important contributing factor in the development of travel-related deep vein thrombosis. This study examined factors affecting popliteal venous blood flow in order to determine the most effective exercise regimen to prevent venous stasis. Methods: Twentyone healthy subjects were randomly assigned to various activities over a 9-week period. Subjects remained seated throughout the investigation and 3660 duplex ultrasound examinations were performed by a single examiner using a SonoSite 180 Plus handheld ultrasound. Baseline popliteal vein blood flow velocity, cross-sectional area and volume flow in subjects sitting motionless were assessed in the first 3 weeks.The remaining 6 weeks involved subjects performing airline-recommended activities, foot exercises, foot exercises against moderate resistance and foot exercises against increased resistance in order to determine the most beneficial method for enhancing popliteal venous flow. Sitting with feet not touching the floor and the effect of sleeping were also assessed. Results: The median age of the subjects was 22 years (range: 18-25.5 years), height 171 cm (162.5-180.5 cm) and body mass index 25.3 kg m -2 (23.2-26.3 kg m -2). Blood volume flow in the popliteal vein was reduced by almost 40% with immobility of seated subjects and by almost 2-fold when sitting motionless with feet not touching the floor. Foot exercises against increased resistance positively enhanced volume flow (P < 0.0001). Conclusion: Leg exercise regimens enhanced popliteal venous flow during prolonged immobility of seated subjects, reinforcing the importance of regular leg movement to prevent venous stasis during prolonged sitting, such as in longdistance travel.

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Section: Introductionmentioning

confidence: 99%

Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

Hitos

Cannon²,

Cannon³

et al. 2007

Journal of Thrombosis and Haemostasis

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“…The risk was up to 15 times higher in passengers known to have inherited thrombophilia and/or have been on oral contraceptives (19,34,51) . Nonetheless, the number of those who had not had a flight but had prolonged road or rail travel was higher; 77% of the cases (26) . In fact, the majority of these case controlled studies have found no link between travel, in general, and the development of VTE (6,24,34,44,57,58,64,82) .…”

Section: Resultsmentioning

confidence: 96%

“…If the condition has to be associated with travel, it must have occurred up to eight weeks after the travel (46) . In eleven case controlled studies, it has been reported that the risk of VTE cases related to travel is more evident in individuals with preexisting risk factors (6,19,24,26,34,44,51,57,58,64,82) . In most of these studies, traveling for at least three hours was associated with increased risk of thrombosis.…”

Section: Resultsmentioning

confidence: 99%

Relation between Air Travel and Venous Thromboembolism

Almotairi¹

2017

jmscr

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“…5,6 From the parameter estimates shown in Table 3 we can estimate q(d), the probability that a VTE admission occurring d days after the most recent international flight was flight-related. Under the null model q(d) is given by where η and ω are the shape and scale parameters of the Weibull distribution, which are estimated from the data.…”

Section: Resultsmentioning

confidence: 99%

Air travel and the risk of deep vein thrombosis

Becker

Salim

Kelman

2006

Australian and New Zealand Journal of Public Health

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Background:The magnitude of the risk of venous thromboembolism (VTE) following air travel has been difficult to resolve due to lack of adequate data. We determine the association more precisely by using a large dataset and an improved method of analysis. Method:Data on air‐travel history for each of 5,196 patients hospitalised for VTE in Western Australia from 1981 to 1999 is analysed using a log‐linear regression model for the probability that a flight triggers VTE and for the baseline hazard rate for VTE hospitalisation. Results:The risk of VTE being triggered on the day of an international flight relative to a flight‐free day is 29.8 (95% CI 22.4‐37.3). Evidence that this relative risk depends on age is weak (p=0.06), but the absolute risk clearly depends on age. The annual relative risk for an individual taking one international flight, compared with an individual of the same age taking no flight, is estimated to be 1.079. The estimated median time from flight to hospital admission is 4.7 days (95% CI 3.8‐5.6) and the estimated 95th percentile is 13.3 (95% CI 10.3‐16.8). Conclusions:Evidence for an association between international air travel and VTE hospitalisation is strong and passengers should be advised on ways to minimise risk during long flights. While 29.8 is a large relative risk, it must be remembered that the baseline risk is very small and the relative risk applies only to the unobserved triggering of a deep vein thrombosis episode on the day of travel; the consequent hospitalisation occurs on one of numerous ensuing days.

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Travel as a Risk Factor for Venous Thromboembolic Disease

Cited by 253 publications

References 17 publications

Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

Relation between Air Travel and Venous Thromboembolism

Air travel and the risk of deep vein thrombosis

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