Thrombosis as a complication of extended stay at high altitude

Citation
Ac. Anand et al., Thrombosis as a complication of extended stay at high altitude, NAT MED J I, 14(4), 2001, pp. 197-201
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
NATIONAL MEDICAL JOURNAL OF INDIA
ISSN journal
0970-258X → ACNP
Volume
14
Issue
4
Year of publication
2001
Pages
197 - 201
Database
ISI
SICI code
0970-258X(200107/08)14:4<197:TAACOE>2.0.ZU;2-T
Abstract
Background. There is limited knowledge about the medical problems of long t erm stay at high (> 3000 m) and extreme (> 5000 m) altitudes, as these area s are generally considered uninhabitable. Methods. Prospectively collected clinical records of all patients hospitali zed at Command Hospital, Western Command between November 1998 and February 2000 were reviewed to identify thrombotic complications among patients fro m high and extreme altitude areas as well as those from non-high altitude a reas who were < 45 years of age. Results. Of 20 257 hospital admissions during the study period, 1692 were f rom high and extreme altitude areas. Forty-six patients from these areas ha d thrombosis-related diseases compared to 17 from non-high altitude areas ( odds ratio: 30.49; 95% Cl: 17.06-51.67; p <0.001). The mean (SD) age of all patients with thrombotic complications was 32 (8) years and all were men. The mean duration of stay at high and extreme altitudes of such patients wa s 10.2 (5.6) months Only 25 were smokers (mean 5.2 pack-years) and 39 consu med alcohol (mean 54 ml/day). Apart from frostbite in 5, no other medical c ondition was noted in these patients. The vascular events were deep vein th rombosis (20), pulmonary thromboembolism (6),stroke(15), thrombosis of the abdominal veins (8), and retinal artery and peripheral arterial thrombosis (1 each). The presenting complaint in all patients with thrombosis of the a bdominal veins was poorly localized pain in the upper abdomen followed by a scites (6/8). Five of these patients also had a large spontaneous splenic h aematoma. None of the patients investigated was found to have a procoagulan t disorder. Conclusion. Long term stay at high and extreme altitudes is associated with a 30 times higher risk of spontaneous vascular thrombosis. Veins are commo n sites of such thrombotic events. We also encountered thrombosis of the po rtal, splenic and superior mesenteric veins in our patients who had stayed at high and extreme altitudes.