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Prophylactic vena cava filter insertion in selected high-risk orthopaedic trauma patients
F B Rogers1, S R Shackford, M A Ricci
1Department of Surgery, University of Vermont College of Medicine, Burlington 05405, USA.
Journal of Orthopaedic Trauma
|May 1, 1997
Summary
Prophylactic vena cava filters significantly reduced pulmonary embolism incidence in orthopaedic trauma patients with minimal morbidity. Inferior vena cava patency remained high at 93.6% over two years.
Area of Science:
- Orthopaedic Surgery
- Trauma Care
- Vascular Surgery
Background:
- Pulmonary embolism (PE) is a significant risk in orthopaedic trauma patients.
- Identifying high-risk patients and effective preventative measures is crucial.
Purpose of the Study:
- To assess the incidence and risk factors of PE in orthopaedic trauma.
- To evaluate the efficacy of prophylactic vena cava filters in preventing PE in high-risk patients.
Main Methods:
- A before-and-after trial design was employed at a Level I trauma center.
- Thirty-five high-risk orthopaedic trauma patients received prophylactic vena cava filters (Greenfield or Bird's Nest).
- Outcomes measured included filter insertion morbidity, PE incidence, and filter patency.
Main Results:
- Prophylactic vena cava filter insertion demonstrated minimal morbidity.
- A significant decrease in PE incidence was observed in the orthopaedic trauma population post-filter introduction (p < 0.04).
- One- and two-year inferior vena cava patency rates were 93.6% +/- 6.2%.
Conclusions:
- Selected use of prophylactic vena cava filters is safe in orthopaedic trauma.
- Vena cava filters effectively decrease the incidence of pulmonary embolism in high-risk orthopaedic trauma patients.