The following is a summary of “An Updated Systematic Review and Meta-analysis of the Impact of Graduated Compression Stockings in Addition to Pharmacological Thromboprophylaxis for Prevention of Venous Thromboembolism in Surgical Inpatients” published in the January 2024 issue of Surgery by Turner, et al.
For a study, researchers sought to find out how often venous thromboembolism (VTE) happens in surgery inpatients who are given pharmacological thromboprophylaxis along with graduated compression stockings (GCSs) versus those who are only given pharmacological thromboprophylaxis.
Surgical inpatients are more likely to have a VTE. New research questions whether GCS protects against VTE more than drug thromboprophylaxis alone. The review used a registered plan and followed the “Preferred Reporting Items for Systematic Reviews and Meta-analyses” standards. The last look at MEDLINE and Embase was in November 2022. They looked at randomized studies that reported the rate of VTE after surgery and used the drug thromboprophylaxis with or without GCS. They combined the rates of deep venous thrombosis (DVT), pulmonary embolism, and death from VTE using both fixed and chance factors.
The chance of DVT was found to be 0.85 (95% CI: 0.54–1.36) for GCS and pharmacological thromboprophylaxis compared to 0.54–1.36 for pharmacological thromboprophylaxis alone (2 studies, 70 events, 2653 subjects). With 33 study arms, 1228 events, and 14,108 people, the risk of DVT was 0.54 (95% CI: 0.23–1.25) for GCS and pharmacological thromboprophylaxis together and 1.25 for pharmacological thromboprophylaxis alone. If you compare GCS and drug prophylaxis to drug prophylaxis alone, the chance of a pulmonary embolism was 0.71 (95% CI: 0.0–30.0) (27 study arms, 32 events, 11,472 subjects). There were no changes in VTE-related deaths between the groups (27 study arms, 3 events, 12,982 subjects).
Head-to-head meta-analysis and pooled study groups show that GCS does not add to the effectiveness of avoiding VTE and death due to VTE. GCS has a chance of skin problems and costs a lot of money. There isn’t enough evidence to back their use for surgery inpatients.
