Purpose:
Inferior vena cava (IVC) filter is vital to prevent pulmonary embolisms (PE) in patients unable to have anticoagulant therapy [1]. However, injury distribution patterns amongst patients and those most likely to benefit from prophylactic IVC filter placement have not been well defined [2]. This project aims to determine the rates of PE post prophylactic IVC filter insertions amongst trauma patients, and its association with injury distribution patterns.
Methods and Materials:
We conducted a retrospective analysis using a prospectively-maintained database of trauma inpatients who had IVC filters inserted between October 2011 to October 2021. All consecutive filter insertions, for both prophylactic and therapeutic indications, during the study period were eligible for inclusion. Exclusion criteria included individuals under the age of 18 years or if patients who passed away during their hospital admission.
Results:
A total of 971 consecutive IVC filter insertions were performed during this time-period. 124 were inserted with a confirmed PE beforehand, and 847 filters were inserted prophylactically [defined as patients with a high venous thromboembolism (VTE) risk but no confirmed VTE]. There were a total of 112 confirmed PEs in our study, of which 26 occurred after filter insertion. All 26 PEs occurred in patients with multi-system injuries as per the abbreviated injury scoring (AIS) system.
Conclusion:
The overall rate of PEs after IVC filter insertion in this single-centre retrospective study was 3.1%. Consequently, IVC filter insertion without anticoagulation may be an alternative option for prevention of VTE amongst patients in whom anticoagulation is contraindicated.