Moreover, according to the guidelines of the American College of Chest Physicians, this limit seems to be different

for individuals with or without additional thrombotic risks. The latter should only perform general measures when traveling longer than 8 hours. Long haul travelers with additional thrombotic risks should perform such general measures already during LHT of less than 8 hours. An exact definition of the duration of LHT, however, has not been given in this recommendation.28 With regard to the performed TP, our data show that again this website travelers’ TR was still the major trigger for the TP. However, the time being seated had significant impact on the performance of a specific TP, too. The longer the traveler was seated, the more likely a specific TP was performed. In accordance with the finding for the recommended TP, the means of transport did not influence the performed TP. Meanwhile, a follow-up conference AG14699 to the meeting in Vienna had been held in Hall/Austria and an updated international consensus statement was published in 2008.25 The main differences between the two recommendations can be found with regard to the

definition of the group with medium TR (Table 1). Most importantly, the comment “Or if at least two of the following factors are present” was deleted in the new recommendation. Therefore, already the presence of one of the listed risk factors leads to the classification as a traveler with medium TR. Although the aspect of two or more existing risk factors is considered in the new recommendation with the statement “The presence of two or more

factors may increase risk in a supra-additive fashion,” it remains unclear whether any combination of risk factors might upgrade the traveler to the high-risk group. However, the authors suggest considering LMWH in special cases of travelers classified in group 2 as this Phosphoglycerate kinase is recommended for travelers with high TR.25 This shows that there is some kind of smooth transition especially between the groups with medium and high TR which offers the consulted physician an individual approach for the particular traveler. Additionally, the risk factors “clinically relevant cardiac disease” and “exsiccosis” had been deleted. We re-analyzed our data after the reclassification of our travelers in accordance to the new risk groups.25 Overall, the changes led to a shift of 97 patients from low to medium TR. With regard to the influence of different variables on the recommended or performed TP, our results did not change. However, when comparing the percentage of travelers in the different risk groups and the recommended or performed TP (Figures 1–4), several interesting observations can be made. First, the percentage among travelers with a low TR being recommended to perform and actually having performed no specific TP increased by approximately 16 and 12%, respectively, when the travelers had been classified according to the Hall recommendation.