Thin air, thick blood: High altitude trauma centers have increased deep venous thrombosis rates

Abstract

Background: Patients undergoing elective procedures at altitudes >4000 ​ft have higher deep venous thrombosis (DVT) rates compared to those performed at ​≤ ​1000 ​ft.

Design: We reviewed the American College of Surgeons Trauma Quality Improvement Program (TQIP) database from 2014 to 2019. Adults are divided into LOW (<1001 ​ft) or HIGH (>4000 ​ft) altitude treatment with DVT rates compared by multivariable regression analysis as well as using a 2:1 propensity matched model.

Results: Risk-adjusted odds ratio (OR) for DVT at high altitude was 1.53 [95 ​% CI 1.42-1.64]. In patients with an Injury Severity Score (ISS) ​≥ ​16, the DVT rate was 1.10 ​% (LOW) vs 1.59 ​% (HIGH); risk-adjusted OR for DVT at high altitude with ISS ​≥ ​16 was 1.67 [1.53-1.83]. Under the propensity matched model, DVT rates at higher altitude had an OR of 1.59 [1.46-1.74].

Conclusion: Following traumatic injury, DVT rates are increased in higher altitude treatment facilities compared to their low elevation peers.