A recent prospective randomized clinical trial sheds light on the safety of early mobilization in patients diagnosed with acute lower limb deep vein thrombosis (DVT). Led by Romera-Villegas et. al.,(2008) the study aimed to investigate whether early mobilization increases the risk of symptomatic pulmonary embolism (PE) and to identify potential predisposing factors for PE, such as thrombus location and duration of symptoms.

The trial, conducted between January 2005 and December 2007, enrolled 219 patients with acute lower limb DVT, with a mean age of 64.2 years. Patients meeting inclusion criteria, including a symptom onset of less than 15 days, life expectancy exceeding one year, absence of life-threatening conditions, and providing informed consent, were randomly assigned to two groups.

Group A consisted of 105 patients who were hospitalized and prescribed five days of bed rest, while Group B comprised 114 patients who received care at home with early ambulation and compression stockings. The primary endpoint of the study was the occurrence of symptomatic PE within the first 10 days of treatment. Additionally, the researchers analyzed potential associations between the duration of symptoms, location of the thrombus, and symptomatic PE.

Results from the trial revealed that out of the total cohort, five cases of symptomatic PE were identified, comprising 2.3% of the patients. Interestingly, three cases occurred in Group B (early mobilization), while two cases were reported in Group A (bed rest). Importantly, the analysis demonstrated no significant difference in the incidence of new PE between the two groups (P=0.54). Furthermore, the duration of symptoms (P=0.62) and the location of the thrombus (P=0.43) were not found to influence the occurrence of symptomatic PE.

In conclusion, the study findings support the safety of early mobilization in patients with acute DVT, as it did not increase the risk of symptomatic PE. Moreover, factors such as thrombus location and duration of symptoms were not associated with a higher incidence of PE. These results underscore the importance of considering early mobilization as a viable approach in the management of acute DVT, potentially offering patients a quicker return to normal activities without compromising safety.

Reference: Romera-Villegas, A., Cairols-Castellote, M. A., Vila-Coll, R., Gómez, A. P. P., Marti-Mestre, X., Bonell-Pascual, A., & Lapiedra-Mur, O. (2008). Early mobilisation in patients with acute deep vein thrombosis does not increase the risk of a symptomatic pulmonary embolism. International angiology, 27(6), 494.