Effect of high elevation on deep vein thrombosis: a multicenter cohort study

Area of Science:

• Medical Research
• Trauma Surgery
• Vascular Medicine

Background:

• Previous studies on elevation and deep vein thrombosis (DVT) had limited elevation ranges and focused on specific trauma subsets.
• This study provides a comprehensive analysis of the association between varying elevations and DVT in all trauma admissions.

Purpose of the Study:

• To investigate the relationship between injury elevation and the incidence of deep vein thrombosis (DVT) in trauma patients.
• To determine if higher elevations are associated with an increased risk of DVT.

Main Methods:

• A retrospective cohort study involving adult trauma patients across four level I trauma centers.
• Injury elevations were determined by zip codes and categorized into high-elevation (≥5000 feet) and low-elevation (<5000 feet) groups.
• Statistical significance was set at an alpha of <0.0001.

Main Results:

• High-elevation injuries (≥5000 feet) were associated with a significantly higher incidence of DVT (1.9%) compared to low-elevation injuries (0.5%).
• Each 1000-foot increase in elevation correlated with a 0.4% average increase in DVT rate.
• After adjusting for covariates, high-elevation injuries showed a 3.8-fold increased risk of DVT.

Conclusions:

• High-elevation injuries are independently associated with a significantly higher risk of developing DVT.
• A positive linear association exists between injury elevation and DVT rates.
• Enhanced DVT screening and prophylaxis may be warranted at higher elevation trauma centers.