HIGH ALTITUDE AND VENOUS THROMBOSIS: FREQUENCY AND RISK FACTORS

  • Qamar Un-Nisa Choudry Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Raheel Iftikhar Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Manzur Qadir Combined Military Hospital Skardu/National University of Medical Sciences (NUMS) Pakistan
  • Tariq Mehmood Satti Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Ghassan Omair Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Syed Kamran Mehmood Armed Forces Bone Marrow Transplant Center/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Keywords: Embolism, Polycythemia, Thrombosis

Abstract

Objective: To determine the effect of high altitude on frequency and risk factors of venous thrombosis in
individuals ascending to high altitude

Study Design: Cross-sectional analytical study.

Place and Duration of Study: Armed Forces Bone Marrow Transplant Centre, Combined Military Hospital
Skardu, from Apr 2015 to Aug 2018.

Methodology: High Altitude was taken as height equal to or more than 8000 feet. Polycythemia as hemoglobin
>16.5 g/dl OR hematocrit >49%. Medical records of all patients evacuated from high altitude through Combined
Military Hospital Skardu were analyzed retrospectively. A proforma was designed to include necessary variables.

Results: We evaluated medical records of 539 individuals and found frequency of 86 (15.9%) for venous thromboembolism (VTE) at high altitude. Cerebral venous sinus thrombosis (CVST) was most common thrombotic complication seen in 39 patients (46%). Majority of thrombotic episodes occurred at >18000 feet (likelihood ratio (LR) 5.99, p-value 0.009). Majority of thrombotic episodes 34 (39%) occurred within first 45 days of ascent to high altitude. Thrombosis was linked to smoking 47 (55%) (likelihood ratio 21.3 and p-value <0.001) and use of melted snow as a source of drinking water 56 (65%) (likelihood ratio 57.6 and p-value <0.001).

Conclusion: This study showed a very high frequency of thrombotic complications at high altitude. There is
a need for a robust prospective study covering epidemiology, clinical information and diagnostics in order to
develop appropriate standard operating procedures and guidelines for prevention of thrombosis at HA

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Published
2021-02-24
How to Cite
Choudry, Q., Iftikhar, R., Qadir, M., Satti, T. M., Omair, G., & Mehmood, S. K. (2021). HIGH ALTITUDE AND VENOUS THROMBOSIS: FREQUENCY AND RISK FACTORS. PAFMJ, 71(1), 107-11. https://doi.org/10.51253/pafmj.v71i1.3173
Section
Original Articles