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Bed rest along with anticoagulation medication is commonly prescribed to patients with acute deep vein thrombosis (DVT). This combination, thought to prevent the development of pulmonary embolus (PE) due to clot migration, has never been scientifically proven to prevent PE. A recent study of 2650 patients (2038 DVT, 612 PE) confirmed the lack of benefit of strict bed rest. Rates of new events related to the initial event were extremely low (0.5% and 0.7%, respectively). Age (>65 years) and presence of cancer were the only variables associated with an increased risk of new PE.
These findings suggest that patients may be counseled to maintain a level of activity that does not cause them increased discomfort after diagnosis of DVT. Pain and swelling may be treated symptomatically with rest, elevation and the use of compression stockings.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.