title: [Bed rest or early mobilization as treatment of deep vein thrombosis: a systematic review and meta-analysis].
abstract: OBJECTIVE
  We aimed to know if treatment of deep vein thrombosis (DVT) with early mobilisation is as safe and effective as bed rest.
  
  
  METHODS
  MEDLINE, EMBASE, Cochrane library (CCTR), Spanish Medical Index, and MD-Consult Virtual Library databases were searched. We also cross-checked bibliographies of the retrieved articles. The TESEO database of doctoral theses in Spain was also revised. We only searched for clinical trial articles comparing bed rest with early mobilization with respect to the incidence of objectively diagnosed pulmonary embolism (PE) in patients treated for DVT of lower limbs. The concordance coefficient was evaluated by statistical methods. We used relative risk and 95% confidence intervals. Selection bias was evaluated using funnel plot.
  
  
  RESULTS
  Only three articles were included in the metaanalysis, with 296 patients randomized from 773 patients initially evaluated, with a follow-up of 9 days to 3 months. Quality rating ranged from 61.4 to 90% and the kappa index of concordance ranged from 0.78 to 0.93. The relative risks of PE between the two groups of treatment (early mobilization versus bed rest) were 1.31 (0.63-2.72), 1.50 (0.17-13.23), and 1.45 (0.56-3.75), respectively, and the global RR was 1.37 (0.78-2.40).
  
  
  CONCLUSIONS
  The analyzed studies reveal that the treatment of DVT with early mobilization rather than bed rest neither increases the rate of PE nor increases the complication rate. New well designed, controlled clinical trials are needed to confirm the conclusions of this review.
authors.affiliation: Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, 29007 Málaga, Spain. javiertrujillo@terra.es
authors.forename: A Javier
authors.initials: AJ
authors.lastname: Trujillo-Santos
authors.forename: Francisco
authors.initials: F
authors.lastname: Martos-Pérez
authors.forename: Emilio
authors.initials: E
authors.lastname: Perea-Milla
mesh_terms: D001510:Bed Rest; D016001:Confidence Intervals; D004434:Early Ambulation; D006801:Humans; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D020246:Venous Thrombosis / Q000628:therapy*