Key result
Reversed pressure gradients in below-knee graded compression stockings were associated with a significantly higher incidence of deep-venous thrombosis than correct gradients (25.6% vs 6.1%; p=0.026).
Why the study?
Does the presence of reversed pressure gradients in below-knee graded compression stockings increase the risk of deep-venous thrombosis in patients undergoing hip or knee replacements?
Observational (n=89)
Does the presence of reversed pressure gradients in below-knee graded compression stockings increase the risk of deep-venous thrombosis in patients undergoing hip or knee replacements?
Absolute Event Rate: 25.6% vs 6.1%
p-value: p=0.026
Reversed pressure gradients in below-knee compression stockings are common and are associated with a significantly increased risk of deep-venous thrombosis in orthopaedic surgery patients.
We recruited 89 patients who had hip or knee replacements to assess the performance of below-knee graded compression stockings. The pressure gradients generated by the stockings were measured and all patients had venography of the ipsilateral leg. We found that 98% of stockings failed to produce the 'ideal' pressure gradient (+/- 20%) of 18, 14 and 8 mmHg from the ankle to the knee, while 54% produced a 'reversed gradient' on at least one occasion during the course of the study. The overall rate of deep-venous thrombosis was 16.7%. Stockings which produced reversed gradients were associated with a significantly higher incidence of deep-venous thrombosis (p = 0.026) than those with the correct gradient (25.6% v 6.1%). This suggests that the performance of graded compression stockings can be improved if reversed pressure gradients are detected and prevented.
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Best et al. (2000) conducted an observational in Hip or knee replacements (n=89). Reversed pressure gradients in graded compression stockings vs. Correct pressure gradients was evaluated on Deep-venous thrombosis (p=0.026). Reversed pressure gradients in below-knee graded compression stockings were associated with a significantly higher incidence of deep-venous thrombosis than correct gradients (25.6% vs 6.1%; p=0.026).
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