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Researchers at the Mayo Clinic in Rochester, Minn., analyzed data on more than 3,700 patients who traveled an average of more than 5,000 miles to have surgery at that medical center.
The study found that the rate of blood clots or pulmonary embolisms within 28 days of surgery was more than 30 times higher in these long-distance travelers than among patients who had short trips or didn't have to travel.
"At medical institutions where patients are traveling a great distance for surgery, physicians should consider it as an additional risk factor," researcher Dr. Juraj Sprung said in a prepared statement.
These patients are at risk for pulmonary embolism, which occurs when a blood clot breaks into smaller pieces that are carried through the blood and become lodged in the blood vessels that supply the lungs. Pulmonary embolism can result in sudden death.
Sprung and his colleagues said patients taking long flights can help prevent blood clots by staying well-hydrated, exercising, and wearing elastic compression stockings. Prescription drugs might also be considered for people at high-risk for blood clots.
The findings appear in the current issue of Mayo Cinic Proceedings.
More information
The American Medical Association has more about pulmonary embolism.
The Brain Attack Coalition, a group of 15 professional, voluntary and government organizations ranging alphabetically from the American College of Neurology to the Veterans Health Administration, published the standards in the June 17 issue of Stroke.
The same coalition issued standards for primary stroke centers nearly five years ago. However, between 30 percent to 35 percent of the 700,000 Americans who have strokes each year require the more specialized treatment available at comprehensive stroke centers, said a statement by the coalition.
"Comprehensive stroke centers require a multidisciplinary team of health-care professionals who are well-trained in the care of stroke patients," said Dr. Mark J. Alberts, a professor of neurology at Northwestern University and lead author of the journal report. "In addition to the need for advanced diagnostic technology, these centers should offer operating rooms and interventional radiology suites that are staffed 24 hours a day, seven days a week, when feasible."
It might take a year or so before the coalition begins an accreditation process for comprehensive centers, said Dr. Lawrence M. Brass, a professor of neurology at Yale University and a spokesman for the American Stroke Association.
"Maybe only a few dozen or a hundred comprehensive centers might be needed," Brass said. "You don't need one in every community."
More basic stroke treatment centers are needed everywhere, he said. "Stroke is so common that it should be treated at every community hospital. One of every six Americans will be affected by some kind of cerebrovascular event during their lifetime," Brass said.
The job of establishing comprehensive centers will be "up to hospitals, in the first few years," he said. "But ultimately some states may start saying, 'Why don't we have one in this state?"
In addition to personnel with expertise in such areas as vascular neurology and neurosurgery, a comprehensive center should have advanced imaging technology such as MRI and digital cerebral angiography, the coalition said. These centers should also be equipped to perform advanced surgical procedures.
There is no cost-benefit analysis yet on comprehensive stroke centers, the group acknowledged.
The public's participation would be necessary for any stroke center to be fully effective, Brass added. Unpleasant as the thought might be, vulnerable people should plan what they would do in case of a stroke, he said.
"You plan for things that are much less likely [than stroke]," Brass pointed out. "If you have hypertension, if you have diabetes, if you are over the age of 65, the chances are over 50 percent that you will die of a heart attack or stroke. So you should know where the best hospitals in the community are, and develop your battle plan for when an event occurs."
More information
For information on stroke and its warning signs, head to the American Heart Association.
Antacids contain calcium, magnesium or aluminum and large doses of each of these can have dangerous side effects. High quantities of calcium can cause kidney stones, too much magnesium can cause diarrhea, and large doses of aluminum can lead to osteomalacia -- a disease in which the bones become brittle and painful.
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