Management of Calf Muscle Venous Thrombosis after Stroke: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Abstract Background and Purpose Calf muscle venous thrombosis (MVT) is a common complication after stroke. However, the optimal management strategy remains controversial. This systematic review aimed to: (1) evaluate the efficacy and safety of early mobilization versus immobilization for MVT prevention and treatment after stroke; (2) compare the effectiveness of different mechanical prophylaxis methods; and (3) analyze the differences in MVT risk and management strategies between patients with intracerebral hemorrhage (ICH) and ischemic stroke (IS). Methods PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI databases were searched for randomized controlled trials (RCTs) comparing early mobilization versus immobilization, different mechanical prophylaxis methods, and observational studies comparing MVT risk between different stroke types. The Cochrane Risk of Bias tool and Newcastle-Ottawa Scale were used to assess study quality. Meta-analysis was performed using RevMan 5.4. Results A total of 8,542 articles were retrieved, and 68 studies were finally included, consisting of 15 randomized controlled trials, 32 cohort studies, 15 case-control studies, and 6 systematic reviews/guidelines. Meta-analysis showed that early mobilization significantly reduced DVT incidence (RR=0.61, 95%CI: 0.48-0.78, P<0.001) without increasing PE risk (RR=0.93, 95%CI: 0.51-1.70, P=0.82). Intermittent pneumatic compression (IPC) was the most effective mechanical prophylaxis method (RR=0.55, 95%CI: 0.42-0.72, P<0.001), while graduated compression stockings (GCS) were ineffective (RR=0.94, 95%CI: 0.74-1.20, P=0.65). Importantly, ICH patients had a significantly higher MVT incidence (5.8%) compared with IS patients (2.1%), with an odds ratio of 7.42 (95%CI: 5.21-10.56, P<0.001). Conclusions Early mobilization is safe and effective for preventing DVT after stroke. IPC is recommended as the first-line mechanical prophylaxis, while GCS should not be used alone. ICH patients have a 7.42-fold higher risk of developing MVT compared with IS patients, highlighting the need for more aggressive prevention strategies in this high-risk population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.020 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.029 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".