A Canadian Multicenter Case-Control Study of the Risk of Venous Thrombosis in Car and Airplane Travelers.
Notice bibliographique
Résumé
Abstract Background: The potential association between venous thromboembolism (VTE) and travel, particularly air travel (“economy class syndrome”), has been the subject of extensive media coverage. While it is biologically plausible that prolonged travel is an independent risk factor for VTE, epidemiological data to date are conflicting, and confounders have rarely been accounted for. Aim: To determine whether there is a greater risk of exposure to travel in patients with confirmed DVT compared with patients in whom DVT is ruled out. To examine the influence of confounding variables on the relation between DVT and travel. Methods: This was a Canadian multi-center case control study. Consecutive patients presenting to the vascular laboratory with clinically suspected DVT were eligible to participate. Cases were patients with objectively confirmed DVT on venous ultrasound; controls were patients in whom DVT was ruled out. Detailed recent travel history, medications and clinical characteristics were obtained via standardized, interviewer-administered questionnaires. Genetic testing for Factor V Leiden and Prothrombin gene mutations was performed. Unconditional multivariate logistic regression analyses with adjustment for confounders and testing for interactions were performed to examine the relation between DVT and (1) any travel, and (2) duration of travel. Plane and car travel were also analyzed separately. Results: There were 359 cases and 359 controls. Mean age among cases was 56 years and 50% were male. Among controls, mean age was 64 years and 35% were male. Body mass index, smoking status and patient location (inpatient vs. out-patient) were comparable between the two groups. The crude and adjusted odds ratio (OR) for exposure to travel in cases was 1.15 (95% confidence interval (CI): 0.78, 1.69) and 1.44 (95%CI: 0.86, 2.40), respectively. Travel of ≥ 12 hours’ duration was associated with a higher OR (adjusted OR 2.92, 95%CI: 0.54, 15.73) than shorter travel durations (adjusted OR 1.29; 95%CI: 0.62, 2.66). Analyzing plane and car travel separately showed that the adjusted OR for plane travel was 2.28 (95%CI: 0.94, 5.50) but for car travel was 1.00 (95%CI: 0.54, 1.83). Increasing durations of plane travel, but not car travel, resulted in higher ORs. For plane travel ≥ 12 hours, the crude OR was 8.22 (95%CI: 1.02, 66.05) and the adjusted OR was 7.10 (95% CI: 0.70, 72.35). No statistical interactions were detected between travel and thrombophilia, hormonal therapy, or clinical VTE risk factors. Interpretation: This is the largest case control study to date of the relation between DVT and travel that takes into account concurrent DVT risk factors. Plane travel but not car travel appears to be a mild independent risk factor for DVT. However, flights of 12 hours or longer were associated with a 7-fold increased risk of DVT. Our findings may have future implications regarding the use of thromboprophylaxis during long-haul travel.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».