Rates and Predictors of Plans for Inferior Vena Cava Filter Retrieval in Hospitalized Patients

被引:39
作者
Mission, John F. [2 ]
Kerlan, Robert K., Jr. [3 ]
Tan, Justin H. [4 ]
Fang, Margaret C. [1 ]
机构
[1] Univ Calif San Francisco, Div Hosp Med, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Sch Med, San Francisco, CA 94143 USA
[3] Univ Calif San Francisco, Sect Intervent Radiol, San Francisco, CA 94143 USA
[4] Univ Calif San Diego, Dept Radiol, San Diego, CA 92103 USA
关键词
inferior vena cava; filter retrieval; deep vein thrombosis; CLINICAL-EXPERIENCE; TRAUMA PATIENTS; PREVENTION; TEMPORARY; OUTCOMES;
D O I
10.1007/s11606-009-1227-y
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Use of inferior vena cava (IVC) filters has been increasing over time. However, because of the increased risk of deep vein thrombosis with permanent filters, placement of retrievable filters has been recommended. Little is known about the factors associated with planned retrieval of IVC filters. To describe rates and predictors of plans to retrieve IVC filters in hospitalized patients. We identified all IVC filter placements from 2001-2006 at an academic medical center and reviewed medical charts to obtain data about patient characteristics, filter retrieval plans, and retrieval success rates. Multivariable logistic regression was used to identify independent predictors of planned filter retrieval in patients with retrievable filters. Out of 240 patients who underwent placement of retrievable IVC filters, only 73 (30.4%) had documented plans for filter retrieval. Factors associated with lower rates of planned filter retrieval included a history of cancer [adjusted odds ratio (OR) and 95% confidence interval 0.2 (0.1-0.5)] and not being discharged on anticoagulants [OR 0.1 (0.1-0.3)]. In addition, 36 (21.6%) of patients without retrieval plans had no contraindications to retrieval. Of the 62 patients who underwent attempted filter retrieval, 25.8% of filters could not be successfully removed. Only 30.4% of patients who underwent placement of a retrievable IVC filter had documented plans for filter removal. Although most patients had justifiable reasons for filter retention, 21.6% of patients had no clear contraindications to filter removal. Efforts to improve rates of filter retrieval in appropriate patients may help reduce the long-term complications of IVC filters.
引用
收藏
页码:321 / 325
页数:5
相关论文
共 30 条
[1]   Retrievable vena cava filters in trauma patients for high-risk prophylaxis and prevention of pulmonary embolism [J].
Allen, TL ;
Carter, JL ;
Morris, BJ ;
Harker, CP ;
Stevens, MH .
AMERICAN JOURNAL OF SURGERY, 2005, 189 (06) :656-661
[2]   Retrievable and permanent inferior vena cava filters: Selected considerations [J].
Anderson, Rockford C. ;
Bussey, Henry I. .
PHARMACOTHERAPY, 2006, 26 (11) :1595-1600
[3]   Initial experience in humans with a new retrievable inferior vena cava filter [J].
Asch, MR .
RADIOLOGY, 2002, 225 (03) :835-844
[4]   Guidelines on use of vena cava filters [J].
Baglin, T. P. ;
Brush, J. ;
Streiff, M. .
BRITISH JOURNAL OF HAEMATOLOGY, 2006, 134 (06) :590-595
[5]   Long-duration temporary vena cava filter: A prospective 104-case multicenter study [J].
Bovyn, Gilles ;
Ricco, Jean-Baptiste ;
Reynaud, Philippe ;
Le Blanche, Alain-Ferdinand .
JOURNAL OF VASCULAR SURGERY, 2006, 43 (06) :1222-1229
[6]  
Chiou Andy C, 2005, Perspect Vasc Surg Endovasc Ther, V17, P329, DOI 10.1177/153100350501700407
[7]   Inferior vena cava filters in the management of venous thromboembolism [J].
Crowther, Mark A. .
AMERICAN JOURNAL OF MEDICINE, 2007, 120 (10) :S13-S17
[8]   A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis [J].
Decousus, H ;
Leizorovicz, A ;
Parent, F ;
Page, Y ;
Tardy, B ;
Girard, P ;
Laporte, S ;
Faivre, R ;
Charbonnier, B ;
Barral, FG ;
Huet, Y ;
Simonneau, G .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (07) :409-415
[9]  
FitzPatrick Mary Kate, 2006, J Trauma Nurs, V13, P45
[10]  
GELBFISH GA, 1991, J VASC SURG, V14, P614