Effect of high elevation on deep vein thrombosis: a multicenter cohort study

1. Injuries suffered at high elevations are associated with a significantly higher odds of developing deep vein thrombosis (DVT) compared to those suffered at low elevations.

Evidence Rating Level: 2 (Good)

Higher altitudes may predispose trauma patients to thrombogenesis through its physiological effects on the body, such as lower partial pressure of oxygen, hemoconcentration alterations, and dehydration. It is important to delineate the relationship between elevation and incidence of DVT because of the associated risk of DVT-related mortality among trauma patients. Previous studies have shown mixed results. This retrospective multicenter cohort study included 8620 patients, 4389 (51%; median [IQR] age, 65.0 [43.0-78.0] years; 48.0% female) of whom suffered injuries at high elevations (H-ELV; > 5000 feet) and 4231 (49%; median [IQR] age, 58.0 [36.0-75.0] years; 46.0% female) of whom suffered injuries at low elevations (L-ELV; < 5000 feet). Patients in the H-ELV group were significantly older, had lower oxygen saturation and higher heart rate, suffered falls and sports injuries more often, and motor vehicle collisions less often, and had a higher rate of comorbidities, including alcohol use disorder and anticoagulant use. These patients had a significantly higher rate of DVT (1.9% vs. 0.5%, p<0.0001). After adjusting for alcohol use disorder and oxygen saturation, this relationship remained (OR 3.8 (95% CI 2.3 to 6.4)). For each 1000-foot increase in elevation, there was a corresponding 0.4% average increase in the rate of DVT. Higher elevations are associated with an increased incidence of DVT. This suggests the potential need for changes to DVT screening protocols or prophylaxis practices at high-elevation centres. Further research is needed to confirm these findings and recommendations.

Read this study in Trauma Surgery & Acute Care Open

Image: PD

©2026 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.