title: Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischemic Stroke Trial.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a well-recognized and preventable complication of acute stroke. Although graduated compression stockings reduce the risk of VTE for patients undergoing operation, their benefit in acute stroke remains uncertain.
  
  
  METHODS
  The relationship between symptomatic VTE (sVTE) and use of stockings using observational data from the Tinzaparin in Acute Ischemic Stroke Trial, which compared 10 days of treatment with tinzaparin (175 IU/kg(-1) or 100 IU/kg(-1)) with aspirin (300 mg), was assessed using logistic regression adjusted for known VTE risk factors and treatment.
  
  
  RESULTS
  sVTE Occurred in 28 patients (1.9%; 18 with deep vein thrombosis and 13 with pulmonary embolism) within 15 days of enrollment in 1479 patients. Patients wearing one or two stockings for any period of time during the first 10 days (n = 803) had a nonsignificant increase (odds ratio 2.45, 95% confidence interval 0.95-6.32) in the risk of sVTE. In contrast, those wearing bilateral stockings for 10 days (n = 374) had a nonsignificant reduction in the odds of sVTE as compared with those who wore no stockings or wore them for less than 10 days (odds ratio 0.65, 95% confidence interval 0.26-1.65). Mild stroke and treatment with tinzaparin were associated with a reduced risk of VTE.
  
  
  CONCLUSIONS
  Bilateral graduated compression stockings may reduce the incidence of VTE by one third for patients with acute ischemic stroke. However, the uncertainty in this finding, low frequency of sVTE, potential for stockings to cause harm, and cost of stockings highlight the need for a large randomized controlled trial to examine the safety and efficacy of stockings in acute stroke.
authors: University of Nottingham, Nottingham, United Kingdom.
authors: Nikola
authors: N
authors: Sprigg
authors: Laura J
authors: LJ
authors: Gray
authors: Philip M W
authors: PM
authors: Bath
authors: Gudrun
authors: G
authors: Boysen
authors: Peter
authors: P
authors: Paul De Deyn
authors: Didier
authors: D
authors: Leys
authors: Ewa
authors: E
authors: Lindenstrøm
authors: Desmond
authors: D
authors: O'neill
authors: Bernd
authors: B
authors: Ringelstein
authors: Jan-Jacob
authors: JJ
authors: van Der Sande