Enhanced DVT Prevention in Non-ICU Medical Patients: a Cohort Study of IPC Plus LMWH vs. LMWH Alone

This study aimed to evaluate whether intermittent pneumatic compression (IPC) combined with low molecular weight heparin (LMWH) is more effective than LMWH alone in preventing lower extremity deep vein thrombosis (DVT) among high-risk, non-ICU medical patients.

This prospective cohort study included non-critically ill medical patients admitted to the Department of Internal Medicine at our hospital from March 2023 to December 2023. Patients with Padua scores ≥ 4 were randomized into two groups: IPC combined with LMWH (experimental group, n = 302) and LMWH alone (control group, n = 213). The primary outcome was the incidence of lower extremity DVT assessed weekly via duplex ultrasound and upon clinical suspicion of venous thromboembolism (VTE) or at discharge.

Baseline characteristics were comparable between the groups, except for higher white blood cell and platelet counts in the IPC+LMWH group. The incidence of lower extremity DVT was significantly lower in the IPC+LMWH group compared to the LMWH-only group (6.6 vs. 12.2%, p = 0.029). Multivariate logistic regression analysis, adjusted for confounders such as age, BMI, coagulation parameters, and other clinical factors, indicated that IPC combined with LMWH significantly reduced the risk of DVT (RR = 0.392, 95% CI: 0.193 - 0.800, p = 0.010).

IPC combined with LMWH is more effective than LMWH alone in reducing the incidence of lower extremity DVT in high-risk, non-ICU medical patients. Further large-scale, rigorously designed studies are warranted to validate these findings.