Interesting, if not relevant topic to be up to date upon:
Venous Thromboembolism and Travel
- The absolute risk of symptomatic VTE after travel is low.
- The risk of travel-related VTE increases with long-haul flights and in individuals with other clinical risk factors for VTE.
The association between venous thromboembolism (VTE) and travel was recognized as early as the 1950s, when John Homans, MD, best remembered in connection with Homans’ sign—pain in the calf on active or passive dorsiflexion of the foot that may signal deep venous thrombosis (DVT)—advised that “physicians should be alert to recognize the significance of lameness after airplane flights, automobile trips and other occasions of a prolonged seated position.”1 This article will review the risk of developing VTE associated with travel.
The notion that prolonged travel in a sedentary position increases the risk of VTE seems easy to accept, and clinicians are accustomed to asking about recent travel when they suspect VTE. However, symptomatic VTE after air travel is rare, as demonstrated in a cohort study of 8755 employees of large international companies and organizations.2 A total of 22 symptomatic, objectively confirmed VTE events occurred within 8 weeks after 102,429 long-haul flights, defined as 4 hours or longer. This corresponded to an absolute risk of 1 VTE event per 4656 long-haul flights.
A systematic review by Philbrick and colleagues also found a low rate of symptomatic VTE after air travel, with an incidence of 0.5 pulmonary embolisms per 1 million travelers presenting on the day of arrival in the airport, and 27 VTEs (pulmonary embolism and DVT) per 1 million travelers presenting within 2 weeks of arrival.3 When ultrasounds are performed routinely in travelers, the rate of diagnosed DVT may be as high as 1.2%, but the majority of cases are asymptomatic. The risk of an asymptomatic DVT progressing to clinically significant disease is currently unknown.
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REFERENCES ALSO PROVIDED, AS WELL AS "MORE ON PREVENTING THIS SERIOUS PROBLEM TO WHICH SOME ORMANY, DEPENDING ON OUR RESPECTIVE POPULATIONS UNDER TREATMENT AND SURVEILLANCE, OF OUR PATIENTS HAVE A PREDILECTION.
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