Graduated Compression Stockings May Not Be Needed After Surgery
Low molecular weight heparin noninferior to LMWH plus GCS for preventing VTE after elective surgery
THURSDAY, May 14, 2020 (HealthDay News) -- For patients undergoing elective surgery, low molecular weight heparin (LMWH) alone is noninferior to LMWH plus graduated compression stockings (GCS) for prevention of venous thromboembolism, according to a study published online May 13 in The BMJ.
Joseph Shalhoub, M.B.B.S., Ph.D., from Imperial College London, and colleagues conducted a randomized noninferiority trial involving 1,905 elective surgical inpatients assessed as being at moderate or high risk for venous thromboembolism. Participants were randomly assigned to either LMWH pharmacothromboprophylaxis alone or LMWH pharmacothromboprophylaxis and GCS.
The intention-to-treat analysis included 1,858 patients. The researchers found that a primary outcome event (imaging-confirmed lower limb deep vein thrombosis with or without symptoms or pulmonary embolism with symptoms within 90 days of surgery) occurred in 1.7 and 1.4 percent of patients in the LMWH alone and LMWH and GCS groups, respectively (risk difference, 0.30 percent; 95 percent confidence interval, −0.65 to 1.26 percent). The 95 percent confidence interval did not cross the noninferiority margin of 3.5 percent, and consequently, LMWH alone was confirmed as noninferior.
"If we consider the potential adverse events and cost of GCS, urgent revision of national and international venous thromboembolism prevention guidelines is recommended," the authors write.
One author disclosed financial ties to the medical device industry.