Increased use of prophylactic vena cava filters in trauma patients failed to decrease overall incidence of pulmonary embolism

Background: Recent studies have reported that placement of vena cava filters (VCFs) early after injury may decrease the incidence of pulmonary embolism (PE) in high-risk trauma patients. Study Design: This was a retrospective review of all trauma patients with placement of VCFs admitted to a single level-1 trauma center between 1989 and 1997. Two cohorts corresponding to years of high or low prophylactic VCF use (PVCF) were compared. Results: Records were reviewed for 299 trauma patients identified as having had placement of a VCE Two hundred forty-eight filters were placed before the diagnosis of PE. During years of low PVCF use, the overall PE incidence was 0.31%; during years of high PVCF use, the incidence of PE was higher at 0.48% (p = 0.045, chi-square). Conclusions: Increased use of PVCFs failed to decrease the overall rate of PE in our trauma patient population. (J Am Coil Surg 1999;189:314-320. (C) 1999 by the American College of Surgeons).