ASSOCIATION OF RISK FACTORS IN MILITARY PERSONNEL WITH PULMONARY EMBOLISM STATIONED AT HIGH ALTITUDE AND SEA LEVEL

Abstract

Objective: To compare the risk factors of pulmonary embolism between military personnel living at sea level and high altitude. Study Design: Prospective cross sectional. Place and Duration of Study: Pak Emirates Military Hospital (PEMH) and Combined Military Hospital (CMH) Rawalpindi, from Oct 2018 to Mar 2019. Methodology: A total of 52 young soldiers presenting with pulmonary embolism were segregated into two equal groups according to the altitude. A thorough history and clinical examination was followed by a battery of biochemical, immunological and radiological tests for confirming diagnosis, establishing complications and ruling out possible cause(s) of pulmonary embolism. Results: Soldiers with pulmonary embolism evacuated from high altitude had a lower body mass index (BMI) (23.5 ± 0.4) and were relatively younger (33.3 ± 1.6 years). The most common presenting symptom was dyspnoea (94.2%) followed by pleuritic chest pain (77%). Majority (92.3%) of the subjects from high altitude had no risk factors for vascular thrombosis in comparison to low landers (77%). Smoking and a relatively high platelet count were the only findings in the soldiers posted at high altitude. Conclusion: In conclusion, high altitude is an uncommon but known cause of pulmonary embolism in army personnel residing at high altitudes. No risk factor other than smoking and a relatively higher platelet count was found in these patients.

Keywords

• high altitude
• hypercoagulability
• hypoxia
• pulmonary embolism
• soldiers