Accidents vasculaires cérébraux reliés au transport aérien long-courrier : une étude observationnelle rétrospective au centre hospitalier universitaire de la Réunion

Abstract : Introduction: from 1968 until the 2010’s, cases of strokes in long haul flight (LHF) described in the literature were mostly cases of paradoxical embolism. Only more recently were other types of strokes emphasised. The highest incidence of strokes in LHF found in the literature is 0.42 per million of passengers. This incidence is low, but studies suggest a different patient risk profile in comparison with the general population. The frequency of LHF between metropolitan France and Reunion Island makes it a good place to conduct our study about strokes in LHF. First we will identify their aetiologies, then we will study their incidence, their distinctives features, and the characteristics of patients. Method: this is an observational retrospective study carried out from January 1st, 2010 up until December 31st, 2016 at the Reunion Island’s general teaching hospital (Saint-Denis, Saint-Pierre). Patients who had a stroke during or in the next 24 hours following a LHF Paris-Reunion have been included. Results: 9 patients have been included: 7 cardioembolic strokes (5 paradoxical embolism, one by atrial fibrillation, and one by left ventricle dyskinesia). The two other cases had unknown aetiology. The incidence is 2.2 strokes per million of passengers travelling in the Paris-Reunion LHF. 33% of patients underwent revascularisation procedure. The middle age is 65,7 and 67% of patients were men. Patients had on average 2.2 cardiovascular risk factors (RF), and at least one thromboembolic RF. Discussion: the over-representation of paradoxical embolism could be linked to the selection of flights longer than 10 hours, and strokes occurring 24 hours after the flight. Although the incidence of strokes in LHF remains low, it is 5 times higher than in the literature. Analysis of patient and stroke characteristics remains cautious and more studies will be required to conclude.
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Master Thesis
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Marion Dubois. Accidents vasculaires cérébraux reliés au transport aérien long-courrier : une étude observationnelle rétrospective au centre hospitalier universitaire de la Réunion. Médecine humaine et pathologie. 2018. ⟨dumas-02064306⟩

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