title: Travel habits and complications in patients treated with vitamin K antagonists: a cross sectional analysis.
abstract: BACKGROUND
  Travel-related conditions have impact on the quality of oral anticoagulation therapy (OAT) with vitamin K-antagonists. No predictors for travel activity and for travel-associated haemorrhage or thromboembolic complications of patients on OAT are known.
  
  
  METHODS
  A standardised questionnaire was sent to 2500 patients on long-term OAT in Austria, Switzerland and Germany. 997 questionnaires were received (responder rate 39.9%). Ordinal or logistic regression models with travel activity before and after onset of OAT or travel-associated haemorrhages and thromboembolic complications as outcome measures were applied.
  
  
  RESULTS
  43.4% changed travel habits since onset of OAT with 24.9% and 18.5% reporting decreased or increased travel activity, respectively. Long-distance worldwide before OAT or having suffered from thromboembolic complications was associated with reduced travel activity. Increased travel activity was associated with more intensive travel experience, increased duration of OAT, higher education, or performing patient self-management (PSM). Travel-associated haemorrhages or thromboembolic complications were reported by 6.5% and 0.9% of the patients, respectively. Former thromboembolic complications, former bleedings and PSM were significant predictors of travel-associated complications.
  
  
  CONCLUSIONS
  OAT also increases travel intensity. Specific medical advice prior travelling to prevent complications should be given especially to patients with former bleedings or thromboembolic complications and to those performing PSM.
authors.affiliation: Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, D-91054 Erlangen, Germany. Electronic address: Juergen.Ringwald@uk-erlangen.de.
authors.forename: Juergen
authors.initials: J
authors.lastname: Ringwald
authors.affiliation: Medical Clinic 1, Department of Cardiology and Pneumology, Central Hospital of Fuerth, D-90766 Fuerth, Germany.
authors.forename: Marina
authors.initials: M
authors.lastname: Lehmann
authors.affiliation: Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, D-91054 Erlangen, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Niemeyer
authors.affiliation: Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, D-91054 Erlangen, Germany.
authors.forename: Isabell
authors.initials: I
authors.lastname: Seifert
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Daubmann
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.affiliation: Center of Rehabilitation Research, University of Potsdam, D-14469 Potsdam, Germany.
authors.forename: Annett
authors.initials: A
authors.lastname: Salzwedel
authors.affiliation: Institute of Transfusion Medicine and Immunohaematology, Department of Molecular Haemostaseology, University Hospital Frankfurt, Red Cross Blood Donor Service Baden-Wuerttemberg - Hessen, D-60528 Frankfurt, Germany; Department of Internal Medicine, Division of Vascular Medicine and Haemostaseology, University Hospital Frankfurt, D-60590 Frankfurt, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Luxembourg
authors.affiliation: Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, D-91054 Erlangen, Germany.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Eckstein
authors.affiliation: Center of Rehabilitation Research, University of Potsdam, D-14469 Potsdam, Germany; Rehabilitation Center Klinik am See, D-15562 Ruedersdorf, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Voeller
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001317:Austria; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006184:Habits; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care; D011795:Surveys and Questionnaires; D013557:Switzerland; D013923:Thromboembolism / Q000209:etiology*; D014195:Travel; D057236:Travel Medicine; D014812:Vitamin K / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Oral anticoagulation; Patient self-management; Travel; Vitamin K-antagonists