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Published on: February 10, 2023
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Travel-Associated Venous Thromboembolism.
Isla McKerrow Johnson1, Joseph Shatzel2, Sven Olson3
1Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Wilderness & Environmental Medicine
|April 4, 2022
Summary
Long-distance travel, especially air travel, is a mild to moderate risk factor for venous thromboembolism (VTE). Risk increases with travel duration, with graduated compression stockings recommended for prevention in at-risk individuals.
Area of Science:
- Medical Science
- Public Health
- Epidemiology
Background:
- Long-distance travel is often presumed to increase the risk of venous thromboembolism (VTE).
- Existing data lack clear evidence on the strength of this association and the efficacy of preventive measures.
- Understanding travel-related VTE risk is crucial for public health recommendations.
Purpose of the Study:
- To systematically review the literature on the association between travel and VTE.
- To evaluate the role and effectiveness of thromboprophylaxis in preventing travel-related VTE.
- To analyze current clinical practice guidelines regarding VTE prevention during travel.
Main Methods:
- Conducted a systematic literature review of 18 relevant studies.
- Summarized and analyzed existing clinical practice guidelines from five major groups.
- Assessed the quality of evidence for travel duration and thromboprophylaxis.
Main Results:
- An association between VTE and travel duration was confirmed, with a mild to moderate effect size (OR 1.1-4).
- A dose-response relationship was observed, with a 26% increased VTE risk for every 2 hours of air travel after 4 hours.
- Evidence quality for travel length and thromboprophylaxis was low; however, graduated compression stockings demonstrated efficacy in VTE prevention.
Conclusions:
- Air travel is identified as a risk factor for VTE, with risk escalating after 4 hours of travel.
- Graduated compression stockings are effective for VTE prophylaxis in travelers with pre-existing risk factors.
- Guidelines generally advise against prophylaxis for low-risk travelers, favoring conservative measures like compression stockings over pharmacologic treatments.
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