Changes in inferior vena cava filter placement and retrieval practice patterns from a population health perspective
Autor: | Sanjay Gupta, Steven Y. Huang, Rahul A. Sheth, Colin J. McCarthy, Sunil A Sheth, Steven Yevich, Stephen R. Lee, Zeyad A. Metwalli, Alda L. Tam, J. Kuban |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Vena Cava Filters Databases Factual Urology Inferior vena cava filter Population health Inferior vena cava 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Statistical significance medicine Humans Radiology Nuclear Medicine and imaging Contraindication Device Removal Retrospective Studies Population Health Radiological and Ultrasound Technology business.industry Gastroenterology Venous Thromboembolism medicine.disease Thrombosis Surgery Treatment Outcome medicine.vein 030220 oncology & carcinogenesis Concomitant Ambulatory cardiovascular system business |
Zdroj: | Abdominal Radiology. 45:3907-3914 |
ISSN: | 2366-0058 2366-004X |
Popis: | Inferior vena cava (IVC) filters are placed to reduce venous thromboembolism (VTE)-related morbidity and mortality, though the evidence supporting this practice is limited. In 2010, the Food and Drug Administration (FDA) released a device safety advisory due to the risk of filter migration, fracture, and thrombosis with long-term use. The purpose of this study was to evaluate trends and predictors for IVCF placement and retrieval over a 10-year time period from a population health perspective. De-identified patient information from the State Inpatient Databases (SID) and the States Ambulatory Surgery and Services Databases (SASD) for Florida and California were used to identify all patients who underwent IVC filter placement from 2005 to 2014 and 2005 to 2011, respectively. Hospital practice patterns were assessed as a function of time as well as IVC filter placement and retrieval volume. Temporal trends were evaluated for statistical significance using the Cochran–Armitage test. A total of 181,260 IVC filters were placed in 178,327 patients over the study period. IVC filter placements peaked in 2010; following the FDA advisory in 2010, however, IVC filter placements monotonically decreased each subsequent year. The proportion of IVCF placement patients with both acute DVT and PE (17.6% vs 11.8%, P < 0.001) at the time of hospitalization increased; likewise, the proportion of IVCF patients with acute DVT or PE with a concomitant acute contraindication to anticoagulation at the time of hospitalization increased as well following 2010 (17.0% vs 11.9%, P < 0.001). From 2005 to 2014, there was a continual increase in both filter retrieval procedures as well overall percentage of filters retrieved. However, estimated retrieval rates remained low, with a retrieval rate of less than 6% in 2014. Following the FDA warning in 2010, there was a significant decrease in IVC filter placements, with filter placements more frequently performed in patients with poorer health. While retrieval rates increased over time, they remained low. |
Databáze: | OpenAIRE |
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