Abstract Number: PB2356
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Prophylaxis
Background: Prevention of air travel-related venous thromboembolism (VTE) remains an area of clinical equipoise and current approaches require further research to ensure they are beneficial and safe for travellers. Previous data from Kuipers et al. suggest that 25% of long-haul air travellers use pharmacological thromboprophylaxis, however this research was performed prior to routine availability of direct oral anticoagulants (DOACs).
Aims:
- To evaluate the preventative strategies used by attendees to international conferences to reduce the risk of VTE.
- To determine if the use of thromboprophylaxis by attendees to international conferences affects the rate of VTE or increases bleeding events when compared to attendees who do not use prophylaxis.
Methods: Attendees of International Society of Thrombosis and Haemostasis (ISTH) Annual Congress 2019 were invited to participate in two online questionnaires. The first questionnaire evaluated risk factors for VTE and thromboprophylaxis used during air travel. Eight weeks after ISTH Congress, a second questionnaire was emailed and evaluated safety outcomes including VTE and bleeding as per ISTH definitions. Ethics approval was obtained from the local ethics review board.
Results: Of 4399 attendees at ISTH 2019, the initial questionnaire was completed by 470 people (response rate 10.6%). After exclusions for unfinished questionnaires and flight time < 3 hours, 403 valid responses were analysed. The second questionnaire was completed by 260 people. Baseline demographics are listed in table 1. Overall, 69% of responders used some form of thromboprophylaxis and 23% used pharmacological prophylaxis table 2. One central venous sinus thrombosis was reported in an attendee who did not use preventative measures. One minor bleed (epistaxis) occurred in a person taking aspirin.
Conclusions: The majority of survey responders used thromboprophylaxis to prevent travel-related VTE. The effect of these measures on rates of thrombosis or bleeding remains unclear and consequently this research will continue at further international medical conferences, including ISTH 2020.
Age, median Range |
47 21 – 82 |
Female gender (%) | 220 (54) |
Weight in kilograms, median Range |
72 41 – 180 |
Height in centimetres, median Range |
170 130 – 201 |
Travel duration in hours, median | 22 |
Class of travel (%) Economy Business First |
117 (29) 279 (69) 7 (2) |
Profession (%) Medical doctor Scientist Nurse Student Other |
281 (69) 74 (18) 18 (5) 12 (3) 18 (5) |
Number of risk factors for venous thromboembolism* (%) 0 1 2 3 |
305 (76) 81 (20) 15 (4) 2 (<1) |
Regular use of antiplatelet/anticoagulation prior to flight (%) | 37 (9) |
*Risk factors collected include: Recent surgery <8 weeks, lower limb injury/immobility, oestrogen use, pregnancy, active malignancy, personal history of VTE, first degree relative with VTE, presence of thrombophilia or none of the above |
[Table 1: Baseline demographics]
Use of preventative measures (n=403) (%) Non-pharmacological prophylaxis only Pharmacological prophylaxis only Both pharmacological and non-pharmacological No prophylaxis Missing data |
184 (46) 22 (5) 73 (18) 123 (31) 1 (<1) |
Number of non-pharmacological measures* used (n=257) (%) 1 2 3 |
149 (58) 90 (35) 18 (7) |
Pharmacological measures (n=95) (%) Anti-platelet agent Low molecular weight heparin Rivaroxaban Apixaban Edoxaban Dabigatran Other |
39 (41) 19 (20) 21 (22) 11 (12) 3 (3) 1 (<1) 1 (<1) |
Venous thromboembolism Deep vein thrombosis Pulmonary embolism Other – central venous sinus thrombosis |
0 0 1 |
Bleeding episodes Major bleeding Clinically relevant non-major bleeding Minor bleeding |
0 0 1 |
*Non pharmacological measures evaluated include: Elastic compression stockings, recommended in-flight exercises and walking every 2 hours |
[Table 2: Results]
To cite this abstract in AMA style:
Stevens H, Campbell S, Waters N, McFadyen J, Tran H. Thromboprophylaxis to International Conferences and Number of Thromboses (PINOT) study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/thromboprophylaxis-to-international-conferences-and-number-of-thromboses-pinot-study/. Accessed May 18, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/thromboprophylaxis-to-international-conferences-and-number-of-thromboses-pinot-study/