Background: Prophylactic inferior vena cava filters (IVCFs) are often placed in trauma patients who cannot receive prophylactic anticoagulation. IVCFs are utilized in an effort to reduce the risk of acute pulmonary embolism (PE) and mortality. This study aims to investigate whether time-to-filter placement is associated with differences in trauma outcomes.
Methods: We conducted a single-center retrospective review of adult trauma patients who underwent prophylactic IVCF placement. Patients were divided into 2 groups based on time-to-filter: 0-48 hours and >48 hours. Outcome measures included post-filter deep vein thrombosis (DVT), post-filter PE, in-hospital mortality, and ICU length of stay (ICU-LOS). Significance was defined as < .05.
Results: During the 6-year study period, 513 patients underwent prophylactic IVCF placement. Both groups were similar with respect to injury severity score (ISS) ( = .540), percent of patients on home anticoagulation (38% and 39%, = .845), abbreviated injury scale (AIS) by anatomic region ( = .899), and traumatic brain injury (TBI) prevalence ( = .182). Time-to-filter was not associated with significant differences in DVT, PE, or in-hospital mortality ( > .05 for all). Filter placement in the first 48 hours was associated with shorter ICU-LOS and hospital-LOS.
Conclusions: Currently, there are no investigations in the trauma literature looking at the impact of time-to-filter on complications related to venous thromboembolism and potential survival benefit. Results of this investigation showed that IVCF placement within the first 48 hours was significantly associated with shorter ICU- and hospital- LOS.
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http://dx.doi.org/10.1177/0003134820949993 | DOI Listing |
Cureus
December 2024
Critical Care Medicine, NMC Specialty Hospital, Abu Dhabi, ARE.
A 50-year-old female presented with a 10-day history of progressive swelling and pain in the left lower extremity, ultimately diagnosed with deep vein thrombosis (DVT) and May-Thurner Syndrome (MTS). Initial ultrasound indicated thrombosis involving the left external iliac, femoral, and popliteal veins, among others. Blood tests revealed normocytic anemia, but thrombophilia screening and other blood markers were normal.
View Article and Find Full Text PDFSurg Endosc
December 2024
Hartford Hospital Metabolic and Bariatric Surgery Program, 80 Seymour Street, Hartford, CT, 06106, USA.
Background: Research on the use of prophylactic inferior vena cave filter (IVCF) placement prior to metabolic and bariatric surgery (MBS) in high risk patients has yielded conflicting results. We evaluated thrombotic events and mortality in patients with a history of venous thromboembolism (VTE) who underwent IVCF placement in anticipation of MBS.
Methods: We queried the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for all patients undergoing primary sleeve gastrectomy or Roux-en-Y gastric bypass from 2015 to 2019 with a history of VTE.
JAMA
December 2024
Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Importance: Inferior vena cava filters (IVCFs) are commonly used to prevent pulmonary embolism in selected clinical scenarios, despite limited evidence to support their use. Current recommendations from professional societies and the US Food and Drug Administration endorse timely IVCF retrieval when clinically feasible. Current IVCF treatment patterns and outcomes remain poorly described.
View Article and Find Full Text PDFJ Orthop Case Rep
October 2024
Department of Orthopaedics, Apollo Hospitals, Navi Mumbai, Maharashtra, India.
Semin Vasc Surg
June 2024
Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL. Electronic address:
Concern regarding the exponential increase in optional utilization of inferior vena cava filters (IVCFs) in the early 2000s with a persistent low retrieval rate nationwide has resulted in increased scrutiny regarding clinical application of IVCFs. IVCFs are used in a variety of clinical scenarios, ranging from thromboembolic protection in patients with deep venous thrombosis and contraindication to anticoagulation to prophylactic deployment in multitrauma and critically ill patients. Evidence supporting IVCFs as mechanical thromboembolic protection in certain clinical scenarios has been established through evidenced-based guidelines.
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