Brief report: graduated compression stocking thromboprophylaxis for elderly inpatients: a propensity analysis.
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.
Labarere
Jose
J
ThEMAS TIMC-IMAG UMR CNRS 5525 UJF, Grenoble, France. JLabarere@chu-grenoble.fr
Bosson
Jean-Luc
JL
Sevestre
Marie-Antoinette
MA
Delmas
Anne-Sophie
AS
Dupas
Stéphane
S
Thenault
Marie-Hélène
MH
Legagneux
Annie
A
Boge
Gudrun
G
Terriat
Béatrice
B
Pernod
Gilles
G
D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D016017:Odds Ratio; D053828:Stockings, Compression / Q000592:standards*; D017211:Treatment Failure; D020246:Venous Thrombosis / Q000453:epidemiology / Q000517:prevention & control*