• Dongdong Zhang, Fenfen Li, Xiaotian Li, and Ganqin Du.
• Resident doctor, Medical master, The First Affiliated Hospital, and College of Clinical Medicine, Henan University of Science and Technology, Luoyang, P.R. China.
• Worldviews Evid Based Nurs. 2018 Jun 1; 15 (3): 189-196.

BackgroundDeep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) are common complications of stroke. However, the effect of intermittent pneumatic compression (IPC) for patients after stroke is uncertain.ObjectivesTo assess the effectiveness and safety of IPC in reducing the risk of DVT, PE, and mortality in stroke patients.MethodsWe searched leading medical databases including Medline, EMBASE, Cochrane Library, Wanfang, CNKI, and CBM, from inception to June 2, 2017. Studies comparing IPC with no IPC in stroke patients were included. Agreement was measured using simple agreement and kappa statistics. The rates of PE, DVT, and mortality were compared. The results were pooled using a fixed effects model to evaluate the differences between the IPC and control groups. If there was significant heterogeneity in the pooled result, a random effect model was used.ResultsWe identified seven randomized controlled trials that included 3,551 stroke patients. The average calculated κ for the various parameters was κ = 0.96 (0.70-1). Overall, IPC significantly reduced the incidence of DVT in stroke patients (risk ratio [RR] = 0.50; 95% confidence interval [CI 0.27, 0.94]). At the same time, IPC increased IPC-related adverse events (RR = 5.71; 95% CI [3.40, 9.58]). Though IPC was associated with a significant increase in survival by 4.5 days during 6 months of follow-up (148-152 days; 95% CI [-0.2, 9.1]), there was a mean gain of only 0.9 days (26.7-27.6 days; 95% CI [2.1, 3.9]) in quality-adjusted survival during the 6-month follow-up. Overall, sensitivity analyses did not alter these findings.Linking Evidence To ActionThis review provides an important basis for preventing DVT in stroke patients, especially in hemorrhagic stroke patients. IPC significantly reduces the risk of DVT and significantly improves survival in a wide variety of patients who are immobile after stroke. However, IPC does not significantly improve quality-adjusted survival. Clinicians should take functional status and quality of life into consideration when making decisions for stroke patients.© 2018 Sigma Theta Tau International.

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