Effectiveness of non-instrumental early mobilization to reduce the incidence of deep vein thrombosis in hospitalized patients: A systematic review and meta-analysis

Abstract

Background: Deep vein thrombosis (DVT) poses a significant health risk, particularly in hospitalized patients with multiple risk factors (cigarette smoking, hypertension, diabetes and obesity). Despite advances in treatment, DVT remains a prevalent complication of hospitalization. Objective: To assess the effectiveness of non-instrumental mobilization in hospitalized patients at high risk of DVT, exploring the challenges and variations in intervention protocols. Design: Systematic review and meta-analysis. Setting(s): Not applicable. Participants: Hospitalized patients at risk of deep vein thrombosis. Methods: A systematic search of three databases was conducted from interception to September 2023 for randomized controlled trials. This study was registered in PROSPERO (CRD42023460485). This study was conducted according to PRISMA 2020 statement. Two authors independently screened the studies and extracted the data. The quality of the studies was evaluated using the Downs and Black checklist and GRADE system. The amount of evidence certainty was assessed using the Cochrane Risk of Bias Assessment tool. Meta-analysis was performed addressing the incidence of deep vein thrombosis during hospitalization. Results: 7 studies were eligible for inclusion which included a total of 1774 participants. Interventions ranged from active and passive ankle exercises to walking. Meta-analysis demonstrated a significant overall effect in favor of non-instrumental early mobilization compared to usual care (RR = 0.55; 95 % CI = 0.41, 0.73; p < 0.0001). Subgroup analysis comparing type of mobilization revealed significant effects for global (RR = 0.54; 95 % CI = 0.38, 0.78; p = 0.001) and remote mobilization (RR = 0.25; 95 % CI = 0.07, 0.86; p = 0.03). Conclusions: Non-instrumental early mobilization is beneficial in reducing the incidence of deep vein thrombosis in hospitalized patients.