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Elastic compression stockings for prevention of deep vein thrombosis
1Northern Vascular Centre, Freeman Hospital, High Heaton, Freeman Road, Newcastle Upon Tyne, UK, NE7 7DN.
Background:
One of the settings in which deep vein thrombosis (DVT) in the lower limb and pelvic veins occurs is prolonged immobilisation in hospital for various surgical and medical illnesses. Use of graduated compression stockings (GCS) in these patients has been proposed to decrease the risk of DVT.
Objectives:
The objective of this review was to determine the magnitude of effectiveness of GCS in preventing DVT in various groups of hospitalised patients.
Search Strategy:
The reviewers searched the Cochrane Peripheral Vascular Disease Group trials register, MEDLINE, and EMBASE and hand searched Indexes Medicus. Various GCS manufacturing companies and the trialists in the ongoing trials were contacted.
Selection Criteria:
Randomised controlled trials (RCT's) involving:. Graduated compression stockings alone. Graduated compression stockings used on a background of any other DVT prophylactic method.
Data Collection And Analysis:
One reviewer extracted the data, assessed the quality of trials and analysed the results (SVA) this was cross-checked and authenticated by the other reviewer (TAL).
Main Results:
A total of 16 RCTs were identified. GCS were applied on the day before surgery or on the day of surgery. GCS were worn up until discharge or until the patients were fully mobile. In the majority of the included studies, DVT was identified by radioactive I 125 uptake test. GCS alone. Nine RCTs were identified in this group. In the treatment group (GCS) of 624 patients, 81 developed DVT (13%) in comparison to the control group of 581 patients, where 154 (27%) had DVT, Peto's odds ratio 0.34 (95% confidence interval 0.25, 0.46) favouring treatment with GCS. GCS on a background of another prophylactic method. Seven RCTs were identified this group. In the treatment group (GCS + another method) of 501 patients, 10 (2%) developed DVT whereas in the control group of 505 patients, 74 (15%) developed DVT, Peto's odds ratio 0.24 (95% confidence interval 0.15, 0.37).
Reviewer'S Conclusions:
Analysis of these RCT's confirm that GCS are effective in diminishing the risk of DVT in hospitalised patients. Data examination also suggests, that GCS on a background of another method of prophylaxis is even more effective than GCS alone.