High-grade patent foramen ovale is a risk factor of unprovoked decompression sickness in recreational divers
Language English Country Netherlands Media print-electronic
Document type Evaluation Study, Journal Article
PubMed
31255461
DOI
10.1016/j.jjcc.2019.04.014
PII: S0914-5087(19)30144-3
Knihovny.cz E-resources
- Keywords
- Decompression sickness, Patent foramen ovale, Risk factors,
- MeSH
- Decompression Sickness etiology MeSH
- Adult MeSH
- Foramen Ovale, Patent complications MeSH
- Middle Aged MeSH
- Humans MeSH
- Diving adverse effects MeSH
- Proportional Hazards Models MeSH
- Prospective Studies MeSH
- Registries MeSH
- Risk Factors MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Evaluation Study MeSH
BACKGROUND: Patent foramen ovale (PFO), male sex, age, and body mass index (BMI) were all identified as potential risk factors of decompression sickness (DCS). It has been debated whether PFO might cause unprovoked DCS (i.e. without violation of decompression procedure) due to paradoxical embolization of venous gas emboli. To date, there are no data on the incidence or risk factors of unprovoked DCS. This study sought to evaluate the risk factors of unprovoked DCS in recreational divers. METHODS: A total of 489 consecutive divers were screened for PFO between January 2006 and January 2014 by means of transcranial Doppler. All patients were prospectively included in the study registry. Survival analysis techniques were used to assess for risk factors for unprovoked DCS. Age, sex, BMI, PFO presence, and grade were analyzed. The total sum of dives was used as a measure of time. RESULTS: The group performed a total of 169,411 dives (mean 346±636). Thirty-six (7%) of the divers suffered from an unprovoked DCS. The frequency of PFO was 97.2% in divers with a history of unprovoked DCS and 35.5% in controls (p<0.001). There was no difference in sex, age, BMI, or total number of dives between the respective groups. In the adjusted Cox proportional hazards model, PFO grade 3 was a major risk factor for unprovoked DCS; there was a slight protective effect of increasing age. CONCLUSIONS: We demonstrated that a high-grade PFO was a major risk factor for unprovoked DCS in recreational scuba divers.
Cardiocentrum Hospital Podlesi Trinec Czech Republic
Hyperbaric Chamber Kladno Regional Hospital Kladno Czech Republic
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