Pulmonary embolism after a long-haul flight.

Area of Science:

• Medical research
• Epidemiology
• Public health

Background:

• Long-haul flights (LHF) are linked to venous thromboembolic disease.
• The actual incidence of pulmonary embolism (PE) post-LHF may be underestimated due to ascertainment challenges.
• Reunion Island offers unique geographic conditions for accurate incidence assessment.

Purpose of the Study:

• To determine the incidence of pulmonary embolism (PE) in individuals recently undertaking a long-haul flight to Reunion Island.
• To establish a precise incidence rate for PE within 30 days of LHF arrival.
• To compare the calculated PE incidence with existing literature data.

Main Methods:

• Retrospective, multi-center descriptive study design.
• Inclusion of all PE cases diagnosed within 30 days of LHF arrival at Reunion Island's four public hospitals (Jan 2015 - Jan 2017).
• Calculation of incidence rates at 7 days, 15 days, and 1 month post-flight, using hospital discharge summary databases.

Main Results:

• A total of 45 PE cases were identified among 1,223,001 LHF passengers over two years.
• The incidence of PE within 1 month of LHF was 36.8 per million travelers.
• Incidence rates were 21.9 per million at 7 days and 29.4 per million at 15 days; mean interval to symptom onset was 7 days.

Conclusions:

• The incidence of PE after LHFs in this study (36.8/million) is significantly higher than previously reported (4.8/million).
• Exhaustive data collection methods likely contributed to the higher observed incidence.
• Further case-control studies are recommended to identify specific risk factors for PE following long-haul flights.