Trial reportBMJ (Clinical research ed.)2020
Graduated compression stockings as adjuvant to pharmaco-thromboprophylaxis in elective surgical patients (GAPS study): randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Venous thromboembolism prophylaxis in adults hospitalised for psychiatric illness: an evidence-based clinical practice guideline developed using GRADE.International journal of clinical pharmacy · 2026Guideline
- Evaluation of venous thromboembolism risk assessment models for hospital inpatients: the VTEAM evidence synthesis.Health technology assessment (Winchester, England) · 2024Pooled it
- A systematic review of venous thromboembolism mechanical prophylaxis devices during surgery.Langenbeck's archives of surgery · 2023Pooled it
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Trial
- Elastic stockings for venous thromboembolism prevention, time to go.Research and practice in thrombosis and haemostasis · 2026Article
- Graduated Compression Stockings for Thromboprophylaxis in Orthopaedic and Trauma Surgery: A Rapid Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Hemostatic abnormalities after trauma resuscitation: challenges and strategies in caring for the critically injured patient.Annals of intensive care · 2025Review
- Article
- Review
- Venous thromboembolism chemical prophylaxis after skull base surgery.Acta neurochirurgica · 2024Article
- Venous Thromboembolism: Review of Clinical Challenges, Biology, Assessment, Treatment, and Modeling.Annals of biomedical engineering · 2024Review
- Black holes in compression therapy: A quest for data.Journal of vascular surgery. Venous and lymphatic disorders · 2024Review
- Article
- Venous Thromboembolism Prophylaxis in Medical and Surgical Patients - What's Our Reality?Cureus · 2023Article
- Postoperative intermittent pneumatic compression for preventing venous thromboembolism in Chinese lung cancer patients: a randomized clinical trial.Thrombosis journal · 2023Article
- Preferences and Practices of Brazilian Orthopedists for Thromboprophylaxis Techniques in Total Knee Arthroplasty: Survey Among Members of the Brazilian Society of Knee Surgery (SBCJ).Revista brasileira de ortopedia · 2022Article
- Implementation of the graduated compression as an adjunct to pharmaco-thromboprophylaxis in surgery trial results across the UK.Phlebology · 2022Article
- [What the (general and abdominal) surgeon should know about thrombosis prophylaxis].Chirurgie (Heidelberg, Germany) · 2022Review
- The changes of the calf-vein deformation and femoral vein peak velocity during ankle pump exercise with or without graduated compression stockings.BMC musculoskeletal disorders · 2022Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
objectivesTo investigate whether the use of graduated compression stockings (GCS) offers any adjuvant benefit when pharmaco-thromboprophylaxis is used for venous thromboembolism prophylaxis in patients undergoing elective surgery.
designOpen, multicentre, randomised, controlled, non-inferiority trial.
settingSeven National Health Service tertiary hospitals in the United Kingdom.
participants1905 elective surgical inpatients (≥18 years) assessed as being at moderate or high risk of venous thromboembolism were eligible and consented to participate.
interventionParticipants were randomly assigned (1:1) to receive low molecular weight heparin (LMWH) pharmaco-thromboprophylaxis alone or LMWH pharmaco-thromboprophylaxis and GCS. OUTCOME MEASURES: The primary outcome was imaging confirmed lower limb deep vein thrombosis with or without symptoms, or pulmonary embolism with symptoms within 90 days of surgery. Secondary outcome measures were quality of life, compliance with stockings and LMWH, lower limb complications related to GCS, bleeding complications, adverse reactions to LMWH, and all cause mortality.
resultsBetween May 2016 and January 2019, 1905 participants were randomised. 1858 were included in the intention to treat analysis (17 were identified as ineligible after randomisation and 30 did not undergo surgery). A primary outcome event occurred in 16 of 937 (1.7%) patients in the LMWH alone group compared with 13 of 921 (1.4%) in the LMWH and GCS group. The risk difference between the two groups was 0.30% (95% confidence interval -0.65% to 1.26%). Because the 95% confidence interval did not cross the non-inferiority margin of 3.5% (P<0.001 for non-inferiority), LMWH alone was confirmed to be non-inferior.
conclusionsFor patients who have elective surgery and are at moderate or high risk of venous thromboembolism, administration of pharmaco-thromboprophylaxis alone is non-inferior to a combination of pharmaco-thromboprophylaxis and GCS. These findings indicate that GCS might be unnecessary in most patients undergoing elective surgery.
trial registrationISRCTN13911492.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.