BACKGROUND: Graduated compression stockings (GCS) are often used for deep vein thrombosis prophylaxis in nonsurgical patients, although evidence on their effectiveness is lacking in this setting. OBJECTIVE: To determine whether prophylaxis with GCS is associated with a decrease in the rate of deep vein thrombosis in nonsurgical elderly patients. METHODS: Using original data from 2 multicenter nonrandomized studies, we performed multivariable and propensity score analyses to determine whether prophylaxis with GCS reduced the rate of deep vein thrombosis among 1,310 postacute care patients 65 years or older. The primary outcome was proximal deep vein thrombosis detected by routine compression ultrasonography performed by registered vascular physicians. RESULTS: Proximal deep vein thrombosis was found in 5.7% (21/371) of the GCS users and in 5.2% (49/939) of the GCS nonusers (odds ratio [OR], 1.09; 95% confidence interval [CI], 0.64-1.84). Although adjusting for propensity score eliminated all differences in baseline characteristics between users and nonusers, the OR for proximal deep vein thrombosis associated with GCS remained nonsignificant in propensity-stratified (adjusted OR, 1.11; 95% CI, 0.59-2.10) and propensity-matched (conditional OR, 0.92; 95% CI, 0.42-2.02) analysis. Similar figures were observed for distal and any deep vein thrombosis. The rates of deep vein thrombosis did not differ according to the length of stockings. CONCLUSIONS: Prophylaxis with GCS is not associated with a lower rate of deep vein thrombosis in nonsurgical elderly patients in routine practice. Randomized studies are needed to assess the efficacy of GCS when properly used in this setting.
BACKGROUND: Graduated compression stockings (GCS) are often used for deep vein thrombosis prophylaxis in nonsurgical patients, although evidence on their effectiveness is lacking in this setting. OBJECTIVE: To determine whether prophylaxis with GCS is associated with a decrease in the rate of deep vein thrombosis in nonsurgical elderly patients. METHODS: Using original data from 2 multicenter nonrandomized studies, we performed multivariable and propensity score analyses to determine whether prophylaxis with GCS reduced the rate of deep vein thrombosis among 1,310 postacute care patients 65 years or older. The primary outcome was proximal deep vein thrombosis detected by routine compression ultrasonography performed by registered vascular physicians. RESULTS: Proximal deep vein thrombosis was found in 5.7% (21/371) of the GCS users and in 5.2% (49/939) of the GCS nonusers (odds ratio [OR], 1.09; 95% confidence interval [CI], 0.64-1.84). Although adjusting for propensity score eliminated all differences in baseline characteristics between users and nonusers, the OR for proximal deep vein thrombosis associated with GCS remained nonsignificant in propensity-stratified (adjusted OR, 1.11; 95% CI, 0.59-2.10) and propensity-matched (conditional OR, 0.92; 95% CI, 0.42-2.02) analysis. Similar figures were observed for distal and any deep vein thrombosis. The rates of deep vein thrombosis did not differ according to the length of stockings. CONCLUSIONS: Prophylaxis with GCS is not associated with a lower rate of deep vein thrombosis in nonsurgical elderly patients in routine practice. Randomized studies are needed to assess the efficacy of GCS when properly used in this setting.
Authors: Elodie Sellier; Jose Labarere; Jean-Luc Bosson; Malika Auvray; Marie-Therese Barrellier; Claire Le Hello; Joel Belmin; Philippe Le Roux; Marie-Antoinette Sevestre Journal: Arch Intern Med Date: 2006-10-23
Authors: L Bressollette; M Nonent; E Oger; J F Garcia; P Larroche; B Guias; P Y Scarabin; D Mottier Journal: Thromb Haemost Date: 2001-08 Impact factor: 5.249
Authors: Raza Alikhan; Alexander T Cohen; Sophie Combe; Meyer M Samama; Louis Desjardins; Amiram Eldor; Charles Janbon; Alain Leizorovicz; Carl-Gustav Olsson; Alexander G G Turpie Journal: Arch Intern Med Date: 2004-05-10
Authors: Paula A Rochon; Kathy Sykora; Susan E Bronskill; Muhammad Mamdani; Geoffrey M Anderson; Jerry H Gurwitz; Sudeep Gill; Jack V Tu; Andreas Laupacis Journal: J Gen Intern Med Date: 2004-06 Impact factor: 5.128
Authors: Jean-Luc Bosson; Jose Labarere; Marie Antoinette Sevestre; Joel Belmin; Laurence Beyssier; Antoine Elias; Alain Franco; Philippe Le Roux Journal: Arch Intern Med Date: 2003-11-24