Table 7.
—[Section 2.7.1] Summary of Findings: Should Graduated Compression Stockings vs No Stockings Be Used in Hospitalized Medical Patients?45,47,48
| Outcome | No. of Participants (Studies) Follow-up | Quality of the Evidence (GRADE) | Relative Effect (95% CI) | Anticipated Absolute Effects |
|
| Baseline Riska | Risk Difference With Graduated Compression Stockings (95% CI) | ||||
| Symptomatic DVT | 1,256 (1 RCT) 1-30 d | Moderate due to imprecisionb | RR, 0.91 (0.63-1.29) | Low risk | |
| 2 per 1,000 | 1 fewer per 1,000 (from 1 fewer to 1 more) | ||||
| High risk | |||||
| 67 per 1,000 | 6 fewer per 1,000 (from 25 fewer to 19 more) | ||||
| Nonfatal pulmonary embolism | 1,256 (1 RCT) 1-30 d | Low due to very serious imprecisionb | RR, 0.65 (0.33-1.31) | Low risk | |
| 2 per 1,000 | 1 fewer per 1,000 (from 1 fewer to 1 more) | ||||
| High risk | |||||
| 39 per 1,000 | 14 fewer per 1,000 (from 26 fewer to 12 more) | ||||
| Overall mortality | 1,321 (2 RCTs) 1-30 d | Moderate due to imprecisionb | RR, 1.06 (0.94-1.20) | 45 per 1,000 | 3 more per 1,000 (from 3 fewer to 9 more) |
| Skin breaks/ulcers/blisters/skin necrosis | 1,256 (1 RCT) 1-30 d | Very low due to imprecision,b indirectness,c and methodologic limitationsd | RR, 4.02 (2.34-6.91) | 13 per 1,000 | 38 more per 1,000 (from 17 more to 75 more) |
| Lower limb ischemia/amputation | 1,256 (1 RCT) 1-30 d | Very low due to very serious imprecisionb and methodologic limitationsd | RR, 3.52 (0.73-16.90) | 2 per 1,000 | 4 more per 1,000 (from 0 fewer to 25 more) |
Number of participants is the number of patients who received graduated compression stockings. See Table 1 and 4 legends for expansion of abbreviations.
Baseline risk for DVT and PE are derived from the RAM by Barbar et al.9 Baseline risk for mortality and bleeding is derived from the control arm of medical patients in a meta-analysis (Dentali et al24). Baseline risk for lower leg ischemia and skin breaks (derived from the control arms of CLOTS trial 1).
We will consider the presence of serious imprecision when there are <300 events in total (events in treatment and control patients) or when confidence intervals include appreciable harms and benefits. The exception is for low-risk patients in whom the absolute difference in PE and DVT is fairly small and precise.
Data on skin breaks are from stroke patients.
Assessment of outcomes was based on case-note review and was not blinded to treatment allocation.