Travel-Associated Venous Thromboembolism.
Travel-Associated Venous Thromboembolism.
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DOI：
10.1016/j.wem.2022.02.004
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发表时间：
2022-06
影响因子：
1.4
通讯作者：
DeLoughery, Thomas G.
中科院分区：
文献类型：
--
作者：
Johnson, Isla McKerrow;Shatzel, Joseph;Olson, Sven;Kohl, Tovah;Hamilton, Andrew;DeLoughery, Thomas G.
长途旅行被认为是静脉血栓栓塞（VTE）的一个危险因素。然而，现有的数据并没有清楚地证明这种关系的强度，也没有证据表明血栓预防的作用。我们对文献进行了系统的回顾。我们还总结了5组可用的指南。我们找到了18项研究来解决这个问题。根据综述中的数据，我们得出结论，静脉血栓栓塞与旅行距离之间存在关联，但这种关联在效应大小上是轻度到中度的，比值比在1.1到4之间。确定了VTE与飞行时间之间的剂量-反应关系，从飞行4小时开始，每飞行2小时，VTE的风险增加26% （P=0.005）。飞行长度和血栓预防的证据质量都很低。然而，低风险的预防措施，如分级压缩长袜被证明是有效的静脉血栓栓塞预防。不同的实践指南之间存在异质性。指南普遍认为，没有已知血栓危险因素的旅行者无需预防，并提倡保守治疗，如加压袜，而不是药物预防。我们得出结论，航空旅行是静脉血栓栓塞的一个危险因素，并且从4小时开始存在剂量关系。对于有危险因素的患者，分级压缩袜是有效的预防措施。
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. We performed a systematic review of the literature. We also summarized available guidelines from 5 groups. 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. 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.
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影响因子：
6.5
作者：
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通讯作者：
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通讯作者：
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作者：
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