Gamer's Thrombosis: A Review of Published Reports

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Abstract

Background: Thrombosis, well known as a condition of the elderly, is occurring in the otherwise healthy adolescent population. Immobility is a significant risk factor for venous thromboembolism (VTE), and adolescents who play video games are immobile for extended periods of time. Some are presenting with VTE. When other risk factors such as obesity are present, the risk of VTE formation increases. We provide a review of published case reports regarding gaming and thrombosis.

Methods: We searched PubMed, Scopus, Web of Science, and EBSCO for articles published through July 2019, using the keywords “computer game thrombosis,” “computer game pulmonary embolism,” “computer game deep vein thrombosis,” “video game thrombosis,” “video game pulmonary embolism,” and “video game deep vein thrombosis.”

Results: Of the 26 articles we identified, we included 12 articles in our review that report a total of 15 cases, of which 2 resulted in fatalities. Modifiable risk factors included cigarette use, being overweight, birth control use, and prolonged immobility. Anticoagulation was the principal treatment modality in patients presenting with gaming thrombosis.

Conclusion: We strongly encourage screening gamers for possible VTEs if clinically warranted.

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Most cited references 38

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Cardiovascular risk factors and venous thromboembolism: a meta-analysis.

Walter Ageno, Cecilia Becattini, Timothy Brighton … (2008)

The concept that venous thromboembolism (VTE) and atherosclerosis are 2 completely distinct entities has recently been challenged because patients with VTE have more asymptomatic atherosclerosis and more cardiovascular events than control subjects. We performed a meta-analysis to assess the association between cardiovascular risk factors and VTE. Medline and EMBASE databases were searched to identify studies that evaluated the prevalence of major cardiovascular risk factors in VTE patients and control subjects. Studies were selected using a priori defined criteria, and each study was reviewed by 2 authors who abstracted data on study characteristics, study quality, and outcomes. Odds ratios or weighted means and 95% confidence intervals (CIs) were then calculated and pooled using a random-effects model. Statistical heterogeneity was evaluated through the use of chi2 and I2 statistics. Twenty-one case-control and cohort studies with a total of 63 552 patients met the inclusion criteria. Compared with control subjects, the risk of VTE was 2.33 for obesity (95% CI, 1.68 to 3.24), 1.51 for hypertension (95% CI, 1.23 to 1.85), 1.42 for diabetes mellitus (95% CI, 1.12 to 1.77), 1.18 for smoking (95% CI, 0.95 to 1.46), and 1.16 for hypercholesterolemia (95% CI, 0.67 to 2.02). Weighted mean high-density lipoprotein cholesterol levels were significantly lower in VTE patients, whereas no difference was observed for total and low-density lipoprotein cholesterol levels. Significant heterogeneity among studies was present in all subgroups except for the diabetes mellitus subgroup. Higher-quality studies were more homogeneous, and significant associations remained unchanged. Cardiovascular risk factors are associated with VTE. This association is clinically relevant with respect to individual screening, risk factor modification, and primary and secondary prevention of VTE. Prospective studies should further investigate the underlying mechanisms of this relationship.

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Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention

John Saunders, Wei Hao, Jiang Long … (2017)

Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%–15% among young people in several Asian countries and of 1%–10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.

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Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007.

C Witmer, Chris Feudtner, Leslie Raffini … (2009)

The goals were to determine whether there has been an increase in the rate of venous thromboembolism (VTE) in pediatric tertiary care hospitals and to evaluate the use of anticoagulants in the treatment of hospitalized pediatric patients with VTE. A retrospective cohort study of patients or =1 coexisting chronic complex medical condition. Pediatric malignancy was the medical comorbid condition associated most strongly with recurrent VTE (P < .001). The proportion of children with VTE who were treated with enoxaparin increased from 29% to 49% during this time period (P < .001); the use of warfarin decreased slightly from 11.4% to 9.6% (P= .02). Increasing age was associated with increased likelihood of patients with VTE being treated with either enoxaparin or warfarin. This multicenter study demonstrates a dramatic increase in the diagnosis of VTE at children's hospitals from 2001 to 2007.

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Journal

Journal ID (nlm-ta): Ochsner J

Journal ID (iso-abbrev): Ochsner J

Journal ID (publisher-id): TOJ

Journal ID (hwp): ochjnl

Title: The Ochsner Journal

Publisher: Academic Division of Ochsner Clinic Foundation

ISSN (Print): 1524-5012

ISSN (Electronic): 1524-5012

Publication date (Print): Summer 2020

Publication date (Electronic): Summer 2020

Volume: 20

Issue: 2

Pages: 182-186

Affiliations

[ ¹ ]Department of Pharmacy , Scripps Mercy Hospital San Diego, San Diego, CA

[ ² ]Department of Pharmacotherapy, University of North Texas Health Science Center College of Pharmacy , Fort Worth, TX

[ ³ ]Department of Pharmacy Practice, Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy , Dallas, TX

Author notes

Address correspondence to Saeed K. Alzghari, MS, MBA (HOM), PharmD, BCPS, Department of Pharmacy Practice, Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy, 5920 Forest Park Rd., Dallas, TX 75235 Tel: (214) 654-9404. Email: saeed.alzghari@ 123456ttuhsc.edu

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Publisher ID: toj.19.0058

DOI: 10.31486/toj.19.0058

PMC ID: 7310170

SO-VID: 510153d7-9372-43eb-a50c-2870c3a8b6d6

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© 2020 by the author(s); licensee Ochsner Journal, Ochsner Clinic Foundation, New Orleans, LA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( creativecommons.org/licenses/by/4.0/legalcode) that permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Gamer's Thrombosis: A Review of Published Reports

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Most cited references 38

Cardiovascular risk factors and venous thromboembolism: a meta-analysis.

Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention

Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007.

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