Introduction
Long-distance travel is assumed to be a risk factor for venous thromboembolism (VTE).
However, the available data have not clearly demonstrated the strength of this relationship,
nor have they shown evidence for the role of thromboprophylaxis.
Methods
We performed a systematic review of the literature. We also summarized available guidelines
from 5 groups.
Results
We found 18 studies that addressed this question. Based on the data presented in the
review, we conclude that there is an association between VTE and length of travel,
but this association is mild to moderate in effect size with odds ratios between 1.1
and 4. A dose-response relationship between VTE and travel time was identified, with
a 26% higher risk for every 2 h of air travel (P=0.005) starting after 4 h. The quality of evidence for both travel length and thromboprophylaxis
was low. However, low-risk prophylactic measures such as graduated compression stockings
were shown to be effective in VTE prevention. There is heterogeneity among the different
practice guidelines. The guidelines generally concur that no prophylaxis is necessary
in travelers without known thrombosis risk factors and advocate for conservative treatment
such as compression stockings over pharmacologic prophylaxis.
Conclusions
We conclude air travel is a risk factor for VTE and that there is a dose relationship
starting at 4 h. For patients with risk factors, graduated compression stockings are
effective prophylaxis.
Keywords
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Article info
Publication history
Published online: March 31, 2022
Accepted:
February 7,
2022
Received:
July 28,
2021
Identification
Copyright
© 2022 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
