BRIEF REPORT: Graduated Compression Stocking Thromboprophylaxis for Elderly Inpatients: A Propensity Analysis
Article first published online: 25 SEP 2006
Journal of General Internal Medicine
Volume 21, Issue 12, pages 1282–1287, December 2006
How to Cite
Labarere, J., Bosson, J.-L., Sevestre, M.-A., Delmas, A.-S., Dupas, S., Thenault, M.-H., Legagneux, A., Boge, G., Terriat, B., Pernod, G. and On behalf of the Association pour la Promotion de l'Angiologie Hospitalière (2006), BRIEF REPORT: Graduated Compression Stocking Thromboprophylaxis for Elderly Inpatients: A Propensity Analysis. Journal of General Internal Medicine, 21: 1282–1287. doi: 10.1111/j.1525-1497.2006.00623.x
- Issue published online: 25 SEP 2006
- Article first published online: 25 SEP 2006
- Manuscript received April 13, 2006Initial editorial decision June 6, 2006Final acceptance August 15, 2006
- prevention and control;
- venous thrombosis
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.