Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial

Background: Venous thromboembolism (VTE) is a well recognised and preventable complication of acute stroke. While graduated compression stockings reduce the risk of VTE in surgical patients their benefit in acute stroke remains uncertain. Methods: The relationship between symptomatic VTE and use of...

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Main Authors: Sprigg, Nikola, Gray, Laura J., Bath, Philip M.W., Boysen, Gudrun, de Deyn, Peter Paul, Leys, Didier, Lindenstrom, Ewa, O'Neill, Desmond, Ringelstein, Bernd, van der Sande, Jan Jacob
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Published: Elsevier 2005
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Online Access:https://eprints.nottingham.ac.uk/677/
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author Sprigg, Nikola
Gray, Laura J.
Bath, Philip M.W.
Boysen, Gudrun
de Deyn, Peter Paul
Leys, Didier
Lindenstrom, Ewa
O'Neill, Desmond
Ringelstein, Bernd
van der Sande, Jan Jacob
author_facet Sprigg, Nikola
Gray, Laura J.
Bath, Philip M.W.
Boysen, Gudrun
de Deyn, Peter Paul
Leys, Didier
Lindenstrom, Ewa
O'Neill, Desmond
Ringelstein, Bernd
van der Sande, Jan Jacob
author_sort Sprigg, Nikola
building Nottingham Research Data Repository
collection Online Access
description Background: Venous thromboembolism (VTE) is a well recognised and preventable complication of acute stroke. While graduated compression stockings reduce the risk of VTE in surgical patients their benefit in acute stroke remains uncertain. Methods: The relationship between symptomatic VTE and use of stockings using observational data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’, which compared 10 days of treatment with tinzaparin (175 IU.kg-1 or 100 IU.kg-1) with, aspirin (300 mg od), was assessed using logistic regression adjusted for known VTE risk factors and treatment. Results: Symptomatic VTE occurred in 28 patients (1.9%, DVT 18, PE 13) within 15 days of enrolment in 1,479 patients. Patients wearing one or two stockings for any period of time during the first 10 days (n=803) had a non-significant increase (odds ratio, OR 2.45, 95% confidence interval, CI 0.95 - 6.32) in the risk of symptomatic VTE. In contrast, those wearing bilateral stockings for 10 days (n=374) had a non-significant reduction in the odds of symptomatic VTE as compared to those who wore no stockings or wore them for less than 10 days (OR 0.65, 95% CI 0.26-1.65). Mild stroke and treatment with tinzaparin were associated with a reduced risk of VTE. Conclusions: Bilateral graduated compression stockings may reduce the incidence of VTE by one-third in patients with acute ischaemic stroke. However, the uncertainty in this finding, low frequency of symptomatic VTE, potential for stockings to cause harm, and cost of stockings highlight the need for a large randomised-controlled trial to examine the safety and efficacy of stockings in acute stroke.
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spelling nottingham-6772020-05-04T20:30:59Z https://eprints.nottingham.ac.uk/677/ Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial Sprigg, Nikola Gray, Laura J. Bath, Philip M.W. Boysen, Gudrun de Deyn, Peter Paul Leys, Didier Lindenstrom, Ewa O'Neill, Desmond Ringelstein, Bernd van der Sande, Jan Jacob Background: Venous thromboembolism (VTE) is a well recognised and preventable complication of acute stroke. While graduated compression stockings reduce the risk of VTE in surgical patients their benefit in acute stroke remains uncertain. Methods: The relationship between symptomatic VTE and use of stockings using observational data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’, which compared 10 days of treatment with tinzaparin (175 IU.kg-1 or 100 IU.kg-1) with, aspirin (300 mg od), was assessed using logistic regression adjusted for known VTE risk factors and treatment. Results: Symptomatic VTE occurred in 28 patients (1.9%, DVT 18, PE 13) within 15 days of enrolment in 1,479 patients. Patients wearing one or two stockings for any period of time during the first 10 days (n=803) had a non-significant increase (odds ratio, OR 2.45, 95% confidence interval, CI 0.95 - 6.32) in the risk of symptomatic VTE. In contrast, those wearing bilateral stockings for 10 days (n=374) had a non-significant reduction in the odds of symptomatic VTE as compared to those who wore no stockings or wore them for less than 10 days (OR 0.65, 95% CI 0.26-1.65). Mild stroke and treatment with tinzaparin were associated with a reduced risk of VTE. Conclusions: Bilateral graduated compression stockings may reduce the incidence of VTE by one-third in patients with acute ischaemic stroke. However, the uncertainty in this finding, low frequency of symptomatic VTE, potential for stockings to cause harm, and cost of stockings highlight the need for a large randomised-controlled trial to examine the safety and efficacy of stockings in acute stroke. Elsevier 2005 Article PeerReviewed Sprigg, Nikola, Gray, Laura J., Bath, Philip M.W., Boysen, Gudrun, de Deyn, Peter Paul, Leys, Didier, Lindenstrom, Ewa, O'Neill, Desmond, Ringelstein, Bernd and van der Sande, Jan Jacob (2005) Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial. Journal of Stroke and Cerebrovascular Disease, 14 (5). pp. 203-209. ISSN 1052-3057 compression stockings tinzaparin symptomatic venous thromboembolism acute ischaemic stroke http://www.elsevier.com/wps/find/journaldescription.cws_home/623369/description#description
spellingShingle compression stockings
tinzaparin
symptomatic venous thromboembolism
acute ischaemic stroke
Sprigg, Nikola
Gray, Laura J.
Bath, Philip M.W.
Boysen, Gudrun
de Deyn, Peter Paul
Leys, Didier
Lindenstrom, Ewa
O'Neill, Desmond
Ringelstein, Bernd
van der Sande, Jan Jacob
Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial
title Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial
title_full Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial
title_fullStr Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial
title_full_unstemmed Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial
title_short Compression stockings and the prevention of symptomatic venous thromboembolism: data from the Tinzaparin in Acute Ischaemic Stroke Trial
title_sort compression stockings and the prevention of symptomatic venous thromboembolism: data from the tinzaparin in acute ischaemic stroke trial
topic compression stockings
tinzaparin
symptomatic venous thromboembolism
acute ischaemic stroke
url https://eprints.nottingham.ac.uk/677/
https://eprints.nottingham.ac.uk/677/