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Increased use of prophylactic vena cava filters in trauma patients failed to decrease overall incidence of pulmonary
A L McMurtry1, J T Owings, J T Anderson
1Section of Trauma/Critical Care, University of California, Davis, Medical Center, Sacramento 95817-2214, USA.
Journal of the American College of Surgeons
|September 3, 1999
Summary
Prophylactic vena cava filters (VCFs) in trauma patients did not reduce pulmonary embolism (PE) rates. Higher use of VCFs was associated with a higher incidence of PE, challenging previous findings.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Pulmonary Medicine
Background:
- Early placement of vena cava filters (VCFs) may reduce pulmonary embolism (PE) in high-risk trauma patients.
- Evidence suggests a potential benefit of VCFs in preventing PE post-injury.
Purpose of the Study:
- To evaluate the impact of prophylactic vena cava filter (PVCF) use on PE incidence in trauma patients.
- To compare PE rates during periods of high versus low PVCF utilization.
Main Methods:
- Retrospective review of 299 trauma patients who received VCFs at a level-1 trauma center (1989-1997).
- Comparison of two cohorts based on high or low prophylactic VCF use.
- Analysis of PE incidence in relation to VCF placement timing.
Main Results:
- A total of 248 VCFs were placed before PE diagnosis.
- PE incidence was 0.31% during low PVCF use years.
- PE incidence was higher at 0.48% during high PVCF use years (p=0.045).
Conclusions:
- Increased use of prophylactic vena cava filters did not decrease the overall PE rate in this trauma patient population.
- Findings suggest that prophylactic VCFs may not be beneficial for reducing PE in trauma patients.