Elastic compression stockings for prevention of deep vein thrombosis (Cochrane Review)

A substantive amendment to this systematic review was last made on 08 November 1999. Cochrane reviews are regularly checked and updated if necessary.

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 and 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 aloneNine 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%) developed 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 methodSeven RCTs were identified in 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).

Reviewers' 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.

Citation: Amaragiri SV, Lees TA. Elastic compression stockings for prevention of deep vein thrombosis (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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