Incidence, clinical characteristics, and long-term prognosis of travel-associated pulmonary embolism
Incidence, clinical characteristics, and long-term prognosis of travel-associated pulmonary embolism
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DOI：
10.1093/eurheartj/ehn500
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发表时间：
2009-01-01
影响因子：
39.3
通讯作者：
Spyridopoulos, Ioakim
中科院分区：
文献类型：
--
作者：
Lehmann, Ralf;Suess, Christian;Spyridopoulos, Ioakim
长时间的空中旅行被认为是肺栓塞（PE）的危险因素。旅行相关性PE（“经济舱综合征”，ECS）患者的临床特征和长期预后在很大程度上仍然未知。由于地理位置优越，我们医院是欧洲第三大机场法兰克福机场的主要转诊中心。本研究的目的是随访1997年至2006年间收治的所有ECS患者。我们系统地回顾了所有急诊室或重症监护室（ICU）的急性PE患者的病历，并对活着出院的患者进行了电话随访。连同法兰克福机场公司统计部门提供的数据，作为法兰克福国际机场的运营公司，我们还能够将医疗数据与相应的乘客数量和飞行距离联系起来。在1997年至2006年期间，共有257例急性PE患者入住我们的急诊和ICU。其中，62例患者患有ECS（45例飞行相关PE和17例其他旅行相关PE）。ECS患者更容易发生血流动力学相关急性事件，反映为初始心肺复苏率较高（4.8% vs. 1.5%; P = 0.153）和大面积PE百分比较高（8% vs. 3%; P = 0.064）。然而，两组的院内死亡率相似（ECS 4.8%，其他4.1%; P = 0.730）。有趣的是，ECS患者的长期结局非常好（Kaplan-Meier分析; P对数秩：0.008 vs.其他实体）。总体而言，ECS是一种罕见事件（1起事件/500万乘客），超过5000 km的长途航班导致的风险是短途航班的17倍。旅行相关PE是我院PE的常见原因，患者出院后显示出良好的长期预后。ECS的风险相当低，并严格取决于飞行距离。
Prolonged air travel is considered a risk factor for pulmonary embolism (PE). The clinical characteristics as well as the long-term prognosis of patients suffering from travel-associated PE ('economy-class syndrome', ECS) remain largely unknown. Owing to its proximity, our hospital is the primary referral centre for Frankfurt Airport, Europe's third-largest airport. The goal of our study was to follow-up all patients with ECS, who were admitted to our hospital between 1997 and 2006.We systematically reviewed all medical charts from patients presenting with acute PE to our emergency room or intensive care unit (ICU) and performed a telephone follow-up on patients discharged alive. Together with the data provided from the statistics department of Fraport Inc., the operating company of the Frankfurt International Airport, we were also able to put the medical data in context with the corresponding number of passengers and flight distances. A total of 257 patients with acute PE were admitted to our emergency and ICU between 1997 and 2006. Out of these, 62 patients suffered from ECS (45 flight-associated PE and 17 from other travel-associated PE). ECS patients were prone to more haemodynamic relevant acute events, reflected by a higher rate of initial cardiopulmonary resuscitation (4.8% vs. 1.5%; P = 0.153) and higher percentage of massive PE (8% vs. 3%; P = 0.064). Nevertheless, intrahospital mortality was similar in both groups (ECS 4.8%, others 4.1%; P = 0.730). Interestingly, the long-term outcome of ECS patients was excellent (Kaplan-Meier analysis; P log-rank: 0.008 vs. other entities). In general, ECS was a rare event (one event/5 million passengers), where long-haul flights over 5000 km lead to a 17-fold risk increase compared with shorter flights.Travel-associated PE was a common cause of PE in our hospital, with patients showing excellent long-term prognosis after discharge. The risk of ECS is rather low and strictly dependent on the flight distance.