Effectiveness of Intermittent Pneumatic Leg Compression for Preventing Deep Vein Thrombosis After Total Hip Replacement
- Russell D. Hull, MBBS, MSc;
- Gary E. Raskob, MSc;
- Michael Gent, MSc;
- Dermot McLoughlin, MBBS;
- Denise Julian, MSc;
- Frank C. Smith, MB, ChB;
- N. Ian Dale, MBBS;
- Roy Reed-Davis, MD;
- Robert N. Lofthouse, MD;
- Christine Anderson, RN
- From the Clinical Trials Unit, Division of General Internal Medicine, University of Calgary, Canada (Dr Hull and Mr Raskob); and the Department of Clinical Epidemiology and Biostatistics (Mr Gent and Ms Julian) and the Sections of Radiology (Dr McLoughlin), Surgery (Drs Smith, Dale, Reed-Davis, and Lofthouse), and Medicine (Ms Anderson), Chedoke-McMaster Hospitals, Hamilton, Canada.
Abstract
A randomized trial was performed in consecutive patients undergoing total hip replacement to evaluate the effectiveness of sequential intermittent calf and thigh compression for preventing venous thrombosis compared with a control group given no prophylaxis. Both groups underwent case finding for deep vein thrombosis using combined fibrinogen I 125 leg scanning, impedance plethysmography, and venography. Deep vein thrombosis by venography was present in 77 (49%) of 158 control patients compared with 36 (24%) of 152 patients given intermittent compression. Proximal vein thrombosis was present in 42 controls (27%) compared with 22 patients (14%) given intermittent compression. Combined impedance plethysmography and leg scanning was insensitive in this patient group (sensitivity, 46%); venography was required to detect more than half the patients with venous thrombosis. Sequential intermittent leg compression clinically and statistically significantly reduced the frequency of both proximal vein and calf vein thrombosis. Case finding resulted in early detection and treatment of patients with venous thrombosis.
(JAMA. 1990;263:2313-2317)
Footnotes
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Reprint requests to the University of Calgary, Department of Medicine, Foothills Hospital, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1 (Dr Hull).
