The use of retrievable inferior vena cava filters in the trauma population

Objective: To determine if the use of retrievable filters resulted in an increase in the placement of inferior vena cava (IVC) filters in trauma patients.

Design: All patients who underwent IVC filter placement at Yale-New Haven Hospital, New Haven, Connecticut, USA between the years 1999 and 2004.

Setting: Academic, level 1 trauma centre.

Patients: Included in the present study were 202 trauma patients and 676 nontrauma patients.

Intervention: IVC filter placement.

Main outcome measure: Demographics, indications, complication rates and type of IVC filters placed in trauma patients versus nontrauma patients were evaluated.

Results: The present study determined 45.4% (n=92) of trauma patients undergoing IVC filter placement were younger than 40 years of age, compared with 7.8% (n=53) of nontrauma patients. The most common indication for IVC filter placement in trauma patients was prophylaxis (n=162, 80.2%), while in the nontrauma patients only 11.4% (n=77) of patients underwent prophylactic filter placement. The number of retrievable filters used in trauma patients increased from 46.7% in 2001, the year they became available, to 78.9% in 2004. The use of retrievable filters similarly increased in the nontrauma population from 35.9% in 2001 to 78.3% in 2004. Approximately 24% of the patients that underwent IVC filter placement at Yale-New Haven Hospital were categorized as trauma patients. The complication rate for this time period was 0.5% (n=1) in the trauma population versus 3.7% (n=26) in the nontrauma population.

Conclusion: The overall number of IVC filters placed in trauma patients did not dramatically increase with the introduction of retrievable filters, suggesting that the indications for the use of IVC filters have not changed.