| 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 immobilization 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 hospitalized 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: Randomized
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 analyzed 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
hospitalized 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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