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| TITLE: | Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis [see comments] | ||||||
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| AUTHORS: | Brandjes DP; Buller HR; Heijboer H; Huisman MV; de Rijk M; Jagt H; ten Cate JW | ||||||
| AUTHOR AFFILIATION: | Centre for Haemostasis, Thrombosis, Atherosclerosis, and Inflammation Research, Academic Medical Centre, Amsterdam, Netherlands. | ||||||
| SOURCE: | Lancet 1997 Mar 15;349(9054):759-62 | ||||||
| CITATION IDS: | PMID: 9074574 UI: 97228496 | ||||||
| COMMENT: | Comment in: ACP J Club 1997 Sep-Oct;127(2):35 | ||||||
| ABSTRACT: | BACKGROUND: Post-thrombotic syndrome varies from mild oedema to incapacitating swelling with pain and ulceration. We investigated the rate of post-thrombotic syndrome after a first episode of deep-vein thrombosis and assessed the preventive effect of direct application of a sized-to-fit graded compression stocking. METHODS: Patients with a first episode of venogram-proven proximal deep-vein thrombosis were randomly assigned no stockings (the control group) or made-to-measure graded compression elastic stockings for at least 2 years. Post- thrombotic syndrome was assessed with a standard scoring system that combined clinical characteristics and objective leg measurements. Patients were assessed every 3 months during the first 2 years, and every 6 months thereafter for at least 5 years. The cumulative incidence of mild-to-moderate post-thrombotic syndrome was the primary outcome measure. FINDINGS: Of the 315 consecutive outpatients considered for inclusion, 44 were excluded and 77 did not consent to take part. 194 patients were randomly assigned compression stockings (n = 96) or no stockings (n = 98). The median follow-up was 76 months (range 60-96) in both groups. Mild-to-moderate post-thrombotic syndrome (score > or = 3 plus one clinical sign) occurred in 19 (20%) patients in the stocking group and in 46 (47%) control-group patients (p < 0.001). 11 (11%) patients in the stocking group developed severe post- thrombotic syndrome (score > or = 4), compared with 23 (23%) patients in the control group (p < 0.001). In both groups, most cases of post- thrombotic syndrome occurred within 24 months of the acute thrombotic event. INTERPRETATION: About 60% of patients with a first episode of proximal deep-vein thrombosis develop post-thrombotic syndrome within 2 years. A sized-to-fit compression stocking reduced this rate by about 50%. | ||||||
| MAIN MESH HEADINGS: |
*Bandages Thrombophlebitis/*therapy | ||||||
| ADDITIONAL MESH HEADINGS: |
Female Follow-Up Studies Human Male Middle Age Patient Compliance Postphlebitic Syndrome/prevention & control Prospective Studies Recurrence Support, Non-U.S. Gov't Treatment Outcome | ||||||
| PUBLICATION TYPES: |
CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL | ||||||
| LANGUAGES: | Eng | ||||||
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