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

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