Thigh-length stockings prevent more DVTs after stroke

January 01, 0001

Thigh-length stockings prevent more DVTs after stroke

Graduated compression stockings are widely used for deep venous thrombosis (DVT) prophylaxis. Although below- knee stockings are used more often than thigh-length stockings, no reliable evidence indicates that they are as effective as thigh- length stockings. The aim of this study was to compare the effectiveness of thigh-length stockings with that of below-knee stockings for preventing proximal DVT in immobile, hospitalized patients with stroke. It consisted of a parallel-group trial with centralized randomization (minimization within centers) involving 112 hospitals in 9 countries and 3114 immobile patients hospitalized with acute stroke between January 2002 and May 2009. 1552 patients received thigh-length stockings and 1562 patients received below-knee stockings to wear while they were in the hospital. Ultrasonographers performed compression duplex ultrasonography.

DVT occurred in 6.3% of patients who received thigh- length stockings and 8.8% who received below-knee stockings, an odds reduction of 31%. Seventy-five percent of patients in both groups wore the stockings for 30 days or until they were discharged, died, or regained mobility. Skin breaks occurred in 3.9% patients who received thigh-length stockings and 2.9% who received below-knee stockings.

The researchers concluded: "Proximal DVT occurs more often in patients with stroke who wear below-knee stockings than in those who wear thigh-length stockings."

We may not be advising the most appropriate length stockings.

For the full abstract, click here.

Annals of Internal Medicine 153(9):553-562, 2 November 2010 © 2010 by the American College of Physicians
Thigh-Length Versus Below-Knee Stockings for Deep Venous Thrombosis Prophylaxis After Stroke: A Randomized Trial. The CLOTS (Clots in Legs Or sTockings after Stroke) Trial Collaboration. Correspondence to Martin Dennis: [email protected]

Category: K. Circulatory. Keywords: stockings, thigh length, below knee, prophylaxis, deep venous thrombosis, stroke, parallel-group trial with centralized randomization, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 26 November 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.