Journal Article

Clinical factors to predict flare-up in patients with inflammatory bowel disease during international air travel: A prospective study

Shin, Cheol Min, Kim, Nayoung, Lee, Dong Ho, Park, Jihye, Park, Young Soo, Yoon, Hyuk

2022

Overview

Inflammatory bowel disease (IBD) patients often experience disease flare-ups during international air travel. We aimed to identify risk factors associated with IBD flare-up during international air travel. Patients with scheduled international air travel were enrolled in the study from the Seoul National University Bundang Hospital IBD clinic. Flight information and clinical data were collected via questionnaires and personal interviews, and risk factors associated with IBD flares were determined. Between May 2018 and February 2020, 94 patients were prospectively enrolled in the study (mean age, 33.0 years; males, 53.2%; mean disease duration, 56.7 months), including 56 (59.6%) with ulcerative colitis and 38 (40.4%) with Crohn's disease. Of the 94 patients enrolled, 15 (16.0%) experienced an IBD flare-up and 79 (84.0%) remained in remission throughout travel. Logistic regression analysis revealed that high fecal calprotectin levels before travel (odds ratio [OR]: 1.001, 95% confidence interval [CI]: 1.000-1.001, p = 0.016), the presence of a comorbidity (OR: 6.334, 95% CI: 1.129-35.526, p = 0.036), and history of emergency room visit (OR: 5.283, 95% CI: 1.085-25.724, p = 0.039) were positively associated with disease flare-up. The previous and current use of immunomodulators and biologics, time of flight, altitude, number countries visited, travel duration, objective of visit, and previous medical consultations were not associated with disease flare-up. Elevated fecal calprotectin levels, history of emergency room visits, and the presence of a comorbidity predicted IBD flare-up during international air travel.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Abdomen / Abdominal surgery / Adult / Air transportation / Air Travel / Aircraft / Biology and Life Sciences / Care and treatment / Colitis - etiology / Colitis - physiopathology / Colitis, Ulcerative - etiology / Colitis, Ulcerative - physiopathology / Comorbidity / Confidence intervals / Crohn Disease - etiology / Crohn Disease - physiopathology / Crohn's disease / Diagnosis / Diarrhea / Earth Sciences / Emergency medical care / Emergency medical services / Engineering and Technology / Feces - chemistry / Female / Health risks / Hospitals / Humans / Immunomodulation / Immunomodulators / Inflammatory bowel disease / Inflammatory bowel diseases / Inflammatory Bowel Diseases - complications / Inflammatory Bowel Diseases - physiopathology / Internal medicine / Intestine / Laboratories / Leukocyte L1 Antigen Complex - analysis / Liver / Male / Medical records / Medical schools / Medicine / Medicine and Health Sciences / Nonsteroidal anti-inflammatory drugs / Outpatient care facilities / Patients / Prognosis / Prospective Studies / Regression analysis / Remission / Remission (Medicine) / Risk analysis / Risk factors / Social Sciences / Statistical analysis / Supervision / Symptom Flare Up / Travel / Ulcerative colitis