Table 15.

—[Section 2.14] Summary of Findings: Early Ambulation vs Delayed Ambulation for Acute DVT of the Leg^{a,b,273,309,310,314,315}

Outcomes	No. of Participants (Studies), Follow-up	Quality of the Evidence (GRADE)	Relative Effect (95% CI)	Anticipated Absolute Effects
				Risk With Delayed Ambulation	Risk Difference With Early Ambulation (95% CI)
Mortality	385 (4 studies), 3 moc	Lowd,e due to risk of bias, imprecision	RR 1.3 (0.23-7.55)	11 per 1,000	3 more per 1,000 (from 8 fewer to 70 more)
PE (symptomatic or asymptomatic)	385 (4 studies), 4-12 d	Lowd-g due to risk of bias, imprecision	RR 1.16 (0.66-2.05)	118 per 1,000	19 more per 1,000 (from 40 fewer to 124 more)
QOL questionnaire in chronic limb venous insufficiency (CIVIQ)	53 (1 study), 2 y	Lowh,i due to risk of bias, indirectness			See footnotej
PTS Villata-Prandoni scores (value, > 5)	37 (1 study), 2 y	Lowe,h due to risk of bias, imprecision	RR 0.66 (0.42-1.03)	400 per 1,000	136 fewer per 1,000 (from 232 fewer to 12 more)

The basis for the assumed risk (eg, the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). Working group grades of evidence are as follow: High quality, further research is very unlikely to change our confidence in the estimate of effect; moderate quality, further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; low quality, further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; very-low quality, we are very uncertain about the estimate. CIVIQ = ChronIc Venous Insufficiency Questionnaire. See Table 1 and 3 legends for expansion of other abbreviations.

^aTwo of four eligible studies excluded patients with symptomatic PE; in the third study, 24% of participants had symptomatic PE at baseline. It was not clear whether the fourth study excluded patients with symptomatic PE.

^bIn two of four eligible trials, all patients received early compression therapy (bandages or stockings). In the two other trials, only patients randomized to early ambulation received early compression therapy.

^cThree studies reporting acute-phase mortality reported no deaths.

^dConcealment of allocation was reported in one of four studies; blinding of outcome assessors was reported in two of four studies; intention-to-treat analysis reported in two of four studies. Follow-up was 97% to 100%. In two of four trials, only patients randomized to early ambulation received early compression therapy (bandages or stockings). In the other two trials, all patients received early compression therapy.

^eCI includes both values of clinically significant benefit and values of clinically significant harms.

^fPE assessed as both symptomatic and asymptomatic PE.

^gFunnel plot reported as not asymmetrical by Aissaoui et al.¹⁵⁶

^hConcealment of allocation was not reported; outcome assessors were not blinded for this outcome. Seventy percent follow-up rate; compression stockings used on patients with early mobilization but not in patients with delayed mobilization.

ⁱNo explanation was provided.

^jPsychologic and overall somatic QOL did not differ significantly between the treatment groups, whereas DVT-related items, especially those reflecting the ease of locomotion, showed significantly greater improvement with compression than with bed rest (P < .001 for bandages, P < .05 for stockings).