Does prophylactic inferior vena cava filter reduce the hazard of pulmonary embolism and mortality in severe trauma? A single center retrospective comparative study.
AIS, Abbreviated Injury Scale
Critical care
DVT, deep venous thrombosis
GCS, Glasgow Coma Scale
HR, Hazard Ratio
ISS, Injury Severity Score
IVC, Inferior Vena Cava
Inferior vena cava filter
Multiple trauma
PE, pulmonary embolism
Patient outcome
Pulmonary embolism
VTE, venous thromboembolism
Venous thromboembolism
Journal
European journal of radiology open
ISSN: 2352-0477
Titre abrégé: Eur J Radiol Open
Pays: England
ID NLM: 101650225
Informations de publication
Date de publication:
2021
2021
Historique:
received:
15
09
2020
revised:
19
11
2020
accepted:
20
11
2020
entrez:
18
12
2020
pubmed:
19
12
2020
medline:
19
12
2020
Statut:
epublish
Résumé
Use of inferior vena cava (IVC) filters in patients following severe trauma without recent history of venous thromboembolism (VTE) is controversial. Our objective was to determine if IVC filter placement in the setting of severe trauma effects the hazard of in-hospital pulmonary embolism (PE), deep venous thrombosis (DVT) and mortality. This retrospective study recruited patients from a single Level I Trauma Center between 1/2008 and 12/2013. Inclusion criteria were age>15 years, Injury Severity Score (ISS)>15 and survival>24 h after hospital admission. Patients with VTE diagnosed prior to IVC filter placement were excluded. A Cox proportional hazards regression model was used, adjusting for immortal time bias with landmark analysis at predefined time after injury. Differences between IVC filter and non-IVC filter groups were adjusted using propensity score. In total 1451 patients were reviewed; 282 patients received an IVC filter and 1169 patients had no IVC filter placed. The mean age was 45.9 vs. 56.9 years and the mean ISS was 29.8 vs. 22.6 in the IVC filter and the non-IVC filter group, respectively. IVC filter placement was not associated with the hazard of PE (HR = 0.46; 95 % CI, 0.12,1.70; P = 0.24) or mortality (HR = 1.02; 95 % CI 0.60,1.75; P = 0.93). However, IVC filter placement was associated with the hazard of DVT (HR = 2.73; 95 % CI, 1.28,5.85; P = 0.01). In patients with severe trauma, those with prophylactic IVC filter placement did not have a reduced hazard of PE or mortality, but an increased hazard of DVT was observed.
Identifiants
pubmed: 33335953
doi: 10.1016/j.ejro.2020.100299
pii: S2352-0477(20)30088-5
pmc: PMC7734225
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100299Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest
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