E-Thrombosis

The current ubiquity of computers has led its users to sit in front of these pieces of equipment for many hours, exposing them to prolonged partial immobility capable of inducing venous thrombosis by adding to other risk factors for thromboembolic disease.

Thrombosis related to the use of computers is a modern technological disease called “electronic thrombosis” or “e-thrombosis”.

– The car, television, video, personal computer, cell phone and other passwords for happiness, machines born to “save time” or to “pass the time”, take over time.

Eduardo Galeano.

Health disorders associated with the arrival of computers

Among the health risks that have come with computers are: Addiction to new technologies, vision disorders, sleep disorders, musculoskeletal problems such as carpal tunnel syndrome, epicondylitis, tendonitis, neck and back pain, etc. . Among the alterations from prolonged use of computers, venous thromboembolic events conformed by venous thrombosis and its derivative, pulmonary thromboembolism, have been described.

Epidemiology of electronic thrombosis

Few cases of e-thrombosis are described, the first in 2003. They have been seen mostly in young men although they are described from childhood to adulthood and occasionally in women. They are generally associated with people with 4 or more hours a day dedicated to sitting in front of a computer. Most of the cases reported in the literature are young people who were playing for several hours without interruption, others (the least) in various activities of work, education and leisure(1).

In a study published in 2008 by West et al(2), sitting immobility, including sitting in front of a computer for more than 8 hours, was found to increase the risk of pulmonary embolism (pulmonary thromboembolism) by up to 1.8 times. Every 1 hour of sitting still increases the cumulative risk by 10%, rising to 20% if you don’t get up.

In a study by Healy et al. that included patients with venous thromboembolism, it was found that a time sitting at the computer greater than 10 hours was associated with a 2.8-fold risk of developing thromboembolic events(3).

In a study by Aldington et al. that included 61 patients with a recent diagnosis of venous embolism thrombus it is reported that 21 of them (34%) experienced prolonged immobility sitting during their work (between 8 and 14 consecutive hours, out of which 1 to 5 went without pause). Most of these patients (67%) were using computing devices. Other identified risk factors were a family history of venous thromboembolism (34%) and a thrombophilic state (31%)⁴. 

E-thrombosis is an entity that may be due to venous stasis and increased pro-coagulant factors in susceptible people with prolonged time sitting in front of a computer.

These findings remind us of the many years spent learning about thrombosis in travelers who spend several hours sitting … which usually occurs when there are other associated risk factors!

Rational prevention of thrombosis associated with the use of computers

The measures to be applied may be similar to those recommended to prevent traveler’s thrombosis also linked to immobility:

• Sit comfortably avoiding keeping your legs crossed.
• Avoid immobility:
  • Do not sit for more than 2 hours in a row.
  • Stand every hour and walk for 5 to 10 minutes.
• Avoid wearing restrictive clothing that reduces venous flow.
• Hydrate often.
• Wear anti-embolic socks.

Suggested readings

1.            Lippi G, Mattiuzzi C, Favaloro EJ. e-thrombosis: epidemiology, physiopathology and rationale for preventing computer-related thrombosis. Ann Transl Med. 2018;6(17). doi:10.21037/atm.2018.09.03

2.            West J, Perrin K, Aldington S, Weatherall M, Beasley R. A case–control study of seated immobility at work as a risk factor for venous thromboembolism. J R Soc Med. 2008;101(5):237-243. doi:10.1258/jrsm.2008.070366

3.            Healy B, Levin E, Perrin K, Weatherall M, Beasley R. Prolonged work- and computer-related seated immobility and risk of venous thromboembolism. J R Soc Med. 2010;103(11):447-454. doi:10.1258/jrsm.2010.100155

4.            Aldington S, Pritchard A, Perrin K, James K, Wijesinghe M, Beasley R. Prolonged seated immobility at work is a common risk factor for venous thromboembolism leading to hospital admission. Intern Med J. 2008;38(2):133-135. doi:10.1111/j.1445-5994.2007.01597.x

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