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Related Experiment Videos

Trends in vena cava filter insertions and "prophylactic" use.

John R Power1, Kenneth R Nakazawa1, Ageliki G Vouyouka2

  • 1Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY.

Journal of Vascular Surgery. Venous and Lymphatic Disorders
|April 22, 2018
PubMed
Summary
This summary is machine-generated.

Prophylactic vena cava filter (VCF) use increased until 2010, when a Food and Drug Administration (FDA) safety alert led to declining rates. Further research is needed to justify VCF use in specific patient groups.

Keywords:
Deep vein thrombosisFDAFood and Drug AdministrationNISNational Inpatient SamplePulmonary embolismVena cava filterVenous thromboembolism

Related Experiment Videos

Area of Science:

  • Vascular surgery
  • Health services research
  • Medical device utilization

Background:

  • Prophylactic vena cava filter (VCF) use in patients without venous thromboembolism (VTE) is a common yet controversial practice.
  • Analysis of the evolution and trends in prophylactic VCF use is lacking.
  • This study identifies key events influencing practice changes in VCF insertion.

Purpose of the Study:

  • To describe trends in prophylactic VCF use in U.S. adult hospitalizations from 2000 to 2014.
  • To identify specific events, such as clinical trials and regulatory alerts, associated with changes in VCF insertion practices.
  • To analyze VCF use trends within subgroups, including trauma patients and those undergoing concurrent surgery.

Main Methods:

  • Retrospective observational study utilizing the National Inpatient Sample (NIS) database.
  • Analysis of trends in prophylactic VCF insertion from 2000 to 2014.
  • Poisson regression analysis to calculate annual percentage change (APC) and assess trend significance.

Main Results:

  • Prophylactic VCF insertion incidence increased from 0.19% to 0.42% by 2010, then decreased to 0.32%.
  • The publication of the PREPIC2 trial in 2005 decelerated the growth rate of VCF use.
  • A 2010 FDA safety alert significantly decreased prophylactic VCF insertions across most patient subgroups, including trauma, orthopedic, and neurosurgical patients.

Conclusions:

  • The FDA safety alert had a more substantial impact on reducing prophylactic VCF use than the PREPIC2 trial.
  • Further investigation is warranted to determine the justification for current prophylactic VCF use in trauma, orthopedic, and neurosurgical patients.