Spectrum of Thrombotic Disorders in Soldiers Serving in High-altitude Areas

JOURNAL TITLE: Journal of Medical Academics

1. Sourya S Mohakuda
2. Sandeep Thareja
3. Narendra Kotwal
4. Muthukrishnan Jayaraman
5. Niket Verma
6. Nalin K Mahesh
7. Sanjeev Kumar
8. Ashwin Mahesh
Publishing Year
Author Affiliations
1. com.mps.common.model.Contributor@468089db ,
2. com.mps.common.model.Contributor@70e98656 ,
3. com.mps.common.model.Contributor@2df948c3 ,
4. com.mps.common.model.Contributor@7e925430 ,
5. com.mps.common.model.Contributor@3c9ec468 ,
6. com.mps.common.model.Contributor@f93e9b ,
7. com.mps.common.model.Contributor@67a1d117 ,
8. com.mps.common.model.Contributor@b7e2a07
Article keywords
Altitude, Soldiers, Thrombosis


Background: Indian soldiers serve in extreme climatic conditions at uninhabitable altitudes. Only few studies and case reports have described various thrombotic disorders in soldiers serving in high altitude (HA). It is postulated that there is activation of intravascular coagulation cascade and factors such as low temperatures, dehydration, polycythemia, stress, and hypoxia have been implicated. Aim: To study the spectrum of thrombotic disorders occurring in soldiers serving in high-altitude areas (>10,000 feet). Setting: The study was conducted at a tertiary-level referral centre for troops deployed in HA regions. The study involved a retrospective analysis of records of patients presenting with thrombotic disorders while being posted to HA. The duration of the study was between February 2012 and March 2014. Materials and methods: Diagnosis, patient particulars, all investigations (including the thrombophilia workup), and treatment given were recorded. Patients with any pre-existing diseases were excluded from the study. Descriptive statistics were used for data analysis. Results: Totally, 69 male patients were presented with thrombotic disorders during the study period. Only 30 (43.4%) patients had pulmonary embolism, 18 (26%) cerebral venous thrombosis, 9 (13%) acute coronary syndrome, 7 (10.1%) deep vein thrombosis, 4 (5.7%) arterial stroke, and 1 (1.4%) had retinal vein thrombosis. An estimated 14 (20.2%) were smokers and 3 (4.3%) patients were highlanders. The procoagulant workup was positive in 10 (14.4%) patients, and 34 (49.2%) patients had polycythemia. The mean duration of stay at HA was 5 ± 2 months. There was no mortality. Conclusion: Only 14.4% of patients showed prothrombotic states. The role of causative factors and the unknown prothrombotic condition in HA needs further investigation by trials involving a larger study population.

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