Long-Haul Air Travel Before Major Surgery: A Prescription for Thromboembolism?

Gajic, Ognjen; Warner, David O.; Decker, Paul A.; Rana, Rimki; Bourke, Denis L.; Sprung, Juraj
June 2005
Mayo Clinic Proceedings;Jun2005, Vol. 80 Issue 6, p728
Academic Journal
OBJECTIVE: To investigate the incidence of postoperative venous thromboembolism (VTE) in patients who had flown long distances before major surgery. PATIENTS AND METHODS: Using the Mayo Clinic computerized patient database, we identified patients who had flown more than 5000 km before major surgery (travelers) and had experienced an episode of clinically significant VTE within 28 days after surgery. Individual medical records were reviewed for the diagnosis of VIE, pertinent risk factors, and outcome. We compared the incidence of VIE in travelers to the incidence of VIE in patients from North America (nontravelers) undergoing similar surgical procedures. RESULTS: Eleven patients met our criteria for long-haul air travel and clinically significant VIE within 28 days after surgery. Compared with nontravelers undergoing similar surgical procedures, long-haul travelers had a higher incidence of VIE (4.9% vs 0.15%; P<.001). Compared with nontravelers who developed VIE, travelers were younger (P=.006), developed VIE earlier in the postoperative course (P=.01), had higher American Society of Anesthesiologists physical status classification (P=.02), and had higher prevalence of smoking (P=.007). Of the 11 travelers with VIE, 10 were of Middle Eastern origin. CONCLUSION: Prolonged air travel before major surgery significantly increases the risk of perioperative VIE. Such patients should receive more Intensive VIE prophylactic measures during the flight and throughout the perioperative period.


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