Knee versus thigh length graduated compression stockings for prevention of deep venous thrombosis: a systematic review.
OBJECTIVE
Graduated compression stockings are a valuable means of thrombo-prophylaxis but it is unclear whether knee-length (KL) or thigh length (TL) stockings are more effective. The aim of this review was to systematically analyse randomised controlled trials that have evaluated stocking length and efficacy of thromboprophylaxis.


METHODS
A systematic review of the literature was undertaken. Clinical trials on hospitalised populations and passengers on long haul flights were selected according to specific criteria and analysed to generate summated data.


RESULTS
14 randomized control trials were analysed. Thirty six of 1568 (2.3%) participants randomised to KL stockings developed a deep venous thrombosis, compared with 79 of 1696 (5%) in the TL control/thigh length group. Substantial heterogeneity was observed amongst trials. KL stockings had a significant effect to reduce the incidence of DVT in long haul flight passengers, odds ration 0.08 (95%CI 0.03-0.22). In hospitalised patients KL stockings did not appear to be far worse than TL stockings, odds ratio 1.01 (95%CI 0.35-2.90). For combined passengers and patients, there was a benefit in favour of KL stockings, weighted odds ratio 0.45 (95% CI 0.30-0.68).


CONCLUSIONS
KL graduated stockings can be as effective as TL stockings for the prevention of DVT, whilst offering advantages in terms of patient compliance and cost.
Sajid
M S
MS
Department of Vascular Surgery, Royal Free Hospital and University College Medical School, Royal Free Campus, Pond Street, Hampstead, London, NW3 2QG, UK.
Tai
N R M
NR
Goli
G
G
Morris
R W
RW
Baker
D M
DM
Hamilton
G
G
D000401:Aircraft; D004867:Equipment Design; D017721:Hospital Costs; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007717:Knee; D016017:Odds Ratio; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012307:Risk Factors; D053828:Stockings, Compression / Q000191:economics / Q000592:standards; D013848:Thigh; D013997:Time Factors; D014195:Travel; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*