Uncertainty underlying the magnitude of risk posed by long distance air travel in venous thromboembolism (VTE) patients has created the need for a deeper, systematic dive into the guidelines and resources providers should be turning to when managing their pre-flight VTE patients.
Jessie Shea (Imperial College London, London, UK) took to the stage at the recent European Venous Forum (EVF 2023; 22–24 June, Berlin, Germany) to deliver the findings of a recent systematic review and meta-analysis of VTE risk in surgical patients with recent air travel.
“A number of studies have shown a positive correlation between VTE risk and long-haul air travel, with incidence rates of up to 5% in patients with concurrent risk factors and an estimated 10–30% of patients with VTE dying within 30 days of incidence,” Shea detailed.
With surgical tourism on the rise, Shea explained that patients opting to endure long-distance flights to seek surgical intervention could be lacking the resources necessary to guide safe air travel. In 2017 alone, there were an estimated 1.4 million US medical tourists, creating a significant need for peri-operative travel guidelines to inform patients of potential risk.
To address the potential risk, Shea et al‘s systematic review and meta-analysis was designed by pulling all available literature about VTE risk in surgery when flying versus surgery at home. To conduct the analysis, the study design collected reporting of incidence of VTE in patients undergoing surgical intervention who had recently engaged in air travel versus those who had not.
Shea detailed that limiting factors for the study included risk of detection or recall basis, heterogeneity in thromboprophylaxis applied, variation in flight characteristics and duration, and impact of other associated VTE risk factors in participating patients.
The presenter concluded that the study found similar rates of VTE in both flying and non-flying surgical patients maintained across subgroup analysis of both preoperative and postoperative air travel, air travel greater than four hours in length and surgery associated with high VTE risk.
“The most important thing is to use a full risk assessment to identify each individual patient’s risk and also take into account the length of surgery,” she said in her closing remarks. “Looking at our study, it would suggest that there is no increase for VTE, but obviously our conclusion is limited by the quality of the evidence.”