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Compression garments for the management of pediatric post-thrombotic syndrome: A prospective longitudinal study
Laura Avila1,2,3, Nour Amiri1,2, Riddhita De1,2
1The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Graduated compression garments (CG) help manage post-thrombotic syndrome (PTS) in children. Wearing CG for 8-12 hours daily, at least 3 days a week, significantly reduces PTS severity scores.
Area of Science:
- Pediatric vascular health
- Thrombosis and anticoagulation
- Medical device efficacy
Background:
- Graduated compression garments (CG) are standard for adult post-thrombotic syndrome (PTS).
- Limited data exists on CG use and efficacy in pediatric populations.
- This study addresses the gap in understanding CG for children with PTS.
Purpose of the Study:
- To assess children's attitudes towards prescribed graduated compression garments (CG).
- To evaluate changes in post-thrombotic syndrome (PTS) severity scores in pediatric patients using CG.
- To provide evidence-based guidance for CG prescription in children.
Main Methods:
- Prospective longitudinal study of children with PTS prescribed CG.
- PTS severity assessed using CAPTSure© at baseline and follow-up.
- Patient attitudes toward CG recorded at follow-up.
Main Results:
- 45 children enrolled (median age 13 years).
- 49% found CG helpful, with 95% of these wearing them ≥3 days/week.
- Wearing CG 8-12 hours/day was associated with a significant reduction in PTS severity scores.
Conclusions:
- Nearly half of pediatric patients found graduated compression garments (CG) helpful for post-thrombotic syndrome (PTS).
- Optimal use involves wearing low-pressure CG for 8-12 hours/day, ≥3 days/week.
- Findings offer guidance for prescribing CG in pediatric PTS management.
Background:
Graduated compression garments (CG) are a standard form of management of post-thrombotic syndrome (PTS) in adults, but data in children are lacking.
Objectives:
We aimed to study the attitudes toward CG and change in PTS severity score in children who were prescribed CG for PTS management.
Methods:
Children with PTS were enrolled in this longitudinal prospective study at the time of CG prescription. PTS severity was measured at baseline and follow-up using CAPTSure© ; attitude toward CG was registered at follow-up.
Results:
Forty-five patients were enrolled (median age 13 years, 25th-75th percentile 8-15 years; 53% male patients); 71% were prescribed socks and 29% sleeves; pressure was 15-20 mmHg in 84% of CG. Median baseline PTS CAPTSure© score was 31 points (25th-75th percentile 21-45 points). At follow-up, 49% of patients found CG helpful, 27% found CG not helpful, and 16% did not buy or wear the CG. Eight percent of enrolled patients did not return for study follow-up. Ninety-five percent of the children who found CG helpful wore them for ≥3 days/week. Hours of CG wear at the time of follow-up were associated with lower PTS scores at follow-up in a non-linear manner (e.g., wearing 12 vs. 0 h/day was associated with a 16-point reduction in PTS scores at follow-up, 95% CI -29 to -2 points).
Conclusion:
Nearly half the patients who were prescribed CG found them helpful. We observed non-linear improvement in PTS severity with the use of low-pressure CG for 8-12 h/day and ≥3 days/week, providing guidance in their prescription.
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