Elastic compression stockings one year after DVT diagnosis: Who might discontinue?
Mol, G. C.; Dronkers, C. E.A.; van de Ree, M. A.; van der Pas, S. L.; Tegelberg-Stassen, M. J.A.M.; Sanders, F. B.M.; Koppen, S.; de Weerdt, O.; Koster, T.; Hovens, M. M.C.; Kaasjager, H. A.H.; Brouwer, R. E.; Kragten, E.; Schaar, C. G.; Spiering, W.; Arnold, W. P.; Huisman, M. V.; Klok, F. A.
(2019) Thrombosis Research, volume 173, pp. 35 - 41
(Article)
Abstract
Background: Elastic compression stockings (ECS) are uncomfortable to wear but may prevent post-thrombotic syndrome (PTS). The ability to predict PTS may help clinical decision making regarding the optimal duration of ECS after deep vein thrombosis (DVT). Aims: Predefined endpoint analysis of the Octavia study that randomized patients who compliantly used
... read more
ECS up to one year after DVT to continue or discontinue ECS treatment. Primary aim was to identify predictors of PTS. Methods: Patient characteristics were collected and ultrasonography was performed to assess reflux, residual thrombosis and persistent thrombus load 12 months after DVT. Multivariable analyses were performed to identify factors related to PTS. Results: Thrombus score ≥ 3, BMI ≥ 26, duration of symptoms before DVT diagnosis ≥ 8 days and a Villalta score of 2–4 points were statistically significant predictors of PTS. The predictive value for PTS for the assessed variables was not different between the 2 treatment groups. In the stop ECS group, 3.2% (95%CI 0.08–18) of patients without any predictors for PTS were diagnosed with mild PTS during follow-up, and none with severe PTS, for a sensitivity of 98% (95% CI 89–100), a specificity of 14% (95% CI 10–20), a positive predictive value of 20% (95% CI 19–22), and a negative predictive value of 97% (95% CI 81–100). Conclusion: We identified 4 predictors of PTS occurring in the 2nd year after DVT. Our findings may be used to decide on whether to continue ECS treatment for an additional year, after one year of compliant ECS use, keeping in mind that patients with none of the predictors will have the lowest PTS incidence.
show less
Download/Full Text
The full text of this publication is not available.
Keywords: Hematology
ISSN: 0049-3848
Publisher: Elsevier Limited
Note: Funding Information: Fonds NutsOhra, Stichting Voorzorg, the Cornelis Vissel Stichting, Sanofi (unrestricted grant), and the Stichting Medicina et Scientia in the Netherlands provided research grants. All analyses were performed independently from the funding source. Funding Information: Fonds NutsOhra , Stichting Voorzorg , the Cornelis Vissel Stichting , Sanofi (unrestricted grant), and the Stichting Medicina et Scientia in the Netherlands provided research grants. All analyses were performed independently from the funding source. Publisher Copyright: © 2018 Elsevier Ltd
(Peer reviewed)