Table 25.

—[Section 4.2.1] Summary of Findings: Compression Stockings vs No Compression Stockings for Patients With PTS^a-c,233,238

Outcomes	No. of Participants (Studies), Follow-up	Quality of the Evidence (GRADE)	Relative Effect (95% CI)	Anticipated Absolute Effects
				Risk With No Compression Stockings	Risk Difference With Compression Stockings (95% CI)
Symptomatic relief treatment successg	115 (2 studies), 12 to 26 mo	Lowd-f due to risk of bias and imprecision	RR 0.96 (0.70-1.31)	579 per 1,000	23 fewer per 1,000 (from 174 fewer to 179 more)
QOL not reported	…		Not estimable
Recurrent VTE not reported	…		Not estimable
Ulcerationh not reported	…		Not estimableh

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. CLOTS1 = Clots in Legs or Stocking After Stroke. See Table 1 and 3 legends for expansion of other abbreviations.

^aGinsberg et al²³³ included patients with PTS 1 y after chronic, typical proximal DVT. Frulla et al²³⁸ included patients with clinical symptoms and signs suggestive of PTS.

^bGinsberg et al²³³: Graduated compression stockings (30-40 mm Hg, calf or thigh length, depending on symptoms). Patients were encouraged to wear stockings as much as possible during waking hours. Frulla et al²³⁸: below-knee graded elastic compression stockings (ECS) (30-40 mm Hg at the ankle). Patients in both study arms received hydroxyethylrutosides (HR) (we considered the ECS 1 HR vs HR comparison).

^cGinsberg et al²³³: placebo stockings (calf or thigh length, depending on symptoms).

^dGinsberg et al²³³: Adequacy of sequence generation and allocation concealment were unclear; patients and outcome assessors were adequately blinded; unclear whether analysis followed the intention-to-treat principle; unclear whether follow-up was complete. Frulla et al²³⁸: outcome assessors were blinded; follow-up was complete; intention-to-treat principle was adhered to, but sequence generation and allocation concealment were unclear, and patients were not blinded.

^eVery small number of patients

^fPublication bias was not detected but not ruled out given that we identified only one small study partially supported by industry (provision of graduated compression stockings).

^gGinsberg et al²³³ reported treatment failure (defined a priori based on any of five clinical criteria, including symptoms and ulcer development). Treatment success refers to the absence of treatment failure. Frulla et al²³⁸ used the Villalta scale.

^hIndirect evidence from the CLOTS1 trial suggests that compression stockings is associated with an RR of 4 for skin complications.