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. 2010 Sep 13;170(16):1456-62.
doi: 10.1001/archinternmed.2010.272.

A population-based study of inferior vena cava filters in patients with acute venous thromboembolism

Frederick A Spencer  1 , Shannon M Bates, Robert J Goldberg, Darleen Lessard, Cathy Emery, Alla Glushchenko, Joel M Gore, Richard H White
Affiliations

A population-based study of inferior vena cava filters in patients with acute venous thromboembolism

Frederick A Spencer et al. Arch Intern Med. .

Abstract

Background: Our study objective was to describe the frequency, indications, and outcomes after inferior vena cava (IVC) filter placement in a population-based sample of residents of the Worcester, Massachusetts, metropolitan area who had been diagnosed as having acute venous thromboembolism (VTE) in 1999, 2001, and 2003.

Methods: A retrospective chart review of inpatient and outpatient medical records was conducted. Recorded indication(s) for IVC filter placement was determined among a subset of cases from 3 Worcester tertiary care hospitals. Three thrombosis specialists assessed the appropriateness of IVC filter placement.

Results: Of 1547 greater Worcester residents with validated acute VTE and without a prior IVC filter, 203 (13.1%) had an IVC filter placed after acute VTE. Patients with an IVC filter were older, had more comorbidities, and had a higher mortality rate during 3 years of follow-up. There was unanimous agreement by panel members that the use of an IVC filter was appropriate in 51% of cases and inappropriate in 26% of cases, with no consensus in the remaining 23%.

Conclusions: In this community-based study, IVC filters were frequently used in the treatment of patients with acute VTE. Placement was deemed to be appropriate in approximately 50% of the patients but was not appropriate or debatable in the remaining cases. Given the increasing use of IVC filters, prospective studies are clearly needed to better define the indications for, and efficacy of, IVC filter placement.

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Figures

Figure 1
Figure 1
Cumulative incidence of recurrent DVT. Kaplan Meier analysis censoring for event, death, or date of last medical record documentation.
Figure 2
Figure 2
Cumulative incidence rate of subsequent/recurrent PE. Kaplan Meier analysis censoring for event, death, or date of last medical record documentation.
Figure 3
Figure 3
Cumulate incidence rate of major bleeding. Kaplan Meier analysis censoring for event, death, or date of last medical record documentation.
Figure 4
Figure 4
Cumulative incidence rate of all-cause mortality. Kaplan Meier analysis censoring for death or date of last medical record documentation.
See this image and copyright information in PMC

References

    1. Hyers TM, Agnelli G, Hull RD, et al. Antithrombotic therapy for venous thromboembolic disease. Chest. 2001 Jan;119(1 Suppl):176S–193S. - PubMed
    1. Decousus H, Leizorovicz A, Parent F, et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med. 1998 Feb 12;338(7):409–415. - PubMed
    1. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest. 2008 Jun;133(6 Suppl):454S–545S. - PubMed
    1. Spencer FA, Emery C, Lessard D, et al. The Worcester Venous Thromboembolism study: a population-based study of the clinical epidemiology of venous thromboembolism. J Gen Intern Med. 2006 Jul;21(7):722–727. - PMC - PubMed
    1. Spencer FA, Gore JM, Lessard D, Douketis JD, Emery C, Goldberg RJ. Patient outcomes after deep vein thrombosis and pulmonary embolism: the Worcester Venous Thromboembolism Study. Arch Intern Med. 2008 Feb 25;168(4):425–430. - PMC - PubMed

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