Comparative Study of Compression Bandages with Absolute Bed Rest versus Ambulation in Treatment of Acute Proximal Deep Vein Thrombosis

Abstract

Background: In general, many patients with acute proximal deep vein thrombosis (DVT) are treated with heparin and oral anticoagulant. Many physicians have been taught to admit these patients to absolute bed rest for the first 24-48 hours due to the fear of dislodging clots that may lead to a fatal pulmonary embolism (PE).
Objective: The aim of this study is to compare the differences among the changing circumference of affected limb, the severity of pain, and the incidence of symptomatic PE in 3 groups of acute proximal DVT, including absolute bed rest with compression bandages (group 1), ambulation with compression bandages (group 2), and ambulation without compression bandages (group 3).
Methods: Between January 2006 and March 2011, 60 patients were enrolled in this study. In this analysis, the clinical characteristics, the changes of affected limb circumference and pain score during the first week of admission and the incidence of symptomatic PE among 3 groups of this study were analyzed. 
Results: There were no statistical differences in the characteristics among 3 groups of patients. The most gender was female and the mean age for 3 groups ranged from 55.1 to 63.7 years. Comparing among 3 groups, it showed a significant difference of calf circumferences between group 1 and group 3. None of the pain score differences were statistically significant among 3 groups. In addition, there was no incidence of symptomatic PE in the three groups of the present study.
Conclusion: Our findings confirm that acute proximal DVT treatment with ambulation does not increase the incidence of symptomatic PE, compared with absolute bed rest. Although there is no statistical decrease of the severity of pain between those 3 groups, the group of absolute bed rest and compression can promote the resolution of calf swelling, compared with the group of ambulation without compression bandages.