MedWire News: US researchers report that thigh-length compression stockings offer no increased protection against deep vein thrombosis (DVT) over knee-length compression stockings.
The findings arise from a meta-analysis of five randomized-controlled trials that compared the efficacy of knee-length and thigh-length compression stockings for inpatient DVT prophylaxis.
Rohit Loomba (Medical College of Wisconsin Affiliated Hospitals, Wauwatosa) and colleagues explain that DVT remains a major cause of morbidity and mortality in hospitalized patients, particularly in those who have undergone an orthopedic procedure or are immobile for other reasons.
Compression stockings represent a reliable, safe, and noninvasive mode of DVT prophylaxis, but both the knee- and thigh-length varieties have their documented advantages and disadvantages related to cost and practicality.
Furthermore, "although randomized trials have studied the efficacy of both varieties in prevention of DVT, selection is often made without regard to evidence," say the researchers.
To summarize the data and guide clinical decision making, Loomba and team systematically reviewed the medical literature and identified five trials that evaluated the efficacy of knee- and thigh-length compression stockings in preventing DVT.
Three of the five trials reported no significant difference in the rate of DVT between the two types of stockings: one showed a reduced DVT risk with knee-length stockings and the other showed a reduced risk with thigh-length stockings.
When the researchers combined the data from all five trials they found that the risk for DVT was marginally higher with knee-length than with thigh-length compression stockings (odds ratio=1.20), but the difference between the two groups was not statistically significant.
Writing in Blood Coagulation and Fibrinolysis, Looma and co-authors say that data from additional large randomized controlled trials "will help further assess the efficacy of thigh-length compression stockings versus knee-length."
Patient compliance, compression size selection, and compression stocking application should also be assessed in these trials along with the incidence of adverse events with both varieties, they add.
The team concludes that decisions regarding the appropriate type of compression stocking to use in the inpatient setting for DVT prophylaxis should "be made on the basis of evidence-based guidelines."
MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
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