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Inferior vena cava filters in patients with cancer and venous thromboembolism (VTE): patterns of use and outcomes
- Source :
- Brunson, A; Ho, G; White, R; & Wun, T. (2016). Inferior vena cava filters in patients with cancer and venous thromboembolism (VTE): Patterns of use and outcomes. Thrombosis Research, 140, S132-S141. doi: 10.1016/S0049-3848(16)30112-8. UC Davis: Retrieved from: http://www.escholarship.org/uc/item/6mt2n5hr
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- © 2016 Elsevier Ltd. All rights reserved. Background Few studies have evaluated the use and outcomes of inferior vena cava filters (IVCF) insertion in cancer patients with deep venous thrombosis (DVT) or pulmonary embolism (PE). Methods Hospital records of patients with a principal diagnosis of lower extremity DVT and/or PE and cancer in California between January 1, 2005 and December 31, 2009 were analyzed. Multivariable logistic regression analysis was used to identify variables associated with IVCF use and propensity matched methodology was used to determine the effect of IVCF insertion on clinical outcomes. Results An IVCF was placed in 19.6% of 14,000 cancer patients and VTE. This varied widely across hospitals, from 0% to 52%, and by cancer type. The strongest predictors of IVCF use were a diagnosis of brain cancer (OR = 4.6, CI: 3.7-5.6), undergoing major surgery (OR = 4.9, CI: 3.9-6.1), and bleeding (OR = 2.7, CI: 2.0-3.5). Only 21% of patients with IVCF had a strong contraindication to anticoagulation (bleeding or major surgery). There was no benefit for 30-day mortality and no reduction in subsequent PE (+/- DVT). Additionally, there was 60% increased risk of recurrent DVT and 20% increased risk of subsequent bleeding when an IVCF was placed. Conclusions An IVCF was placed in approximately 20% of acute VTE patients with cancer and use varied widely between hospitals and cancer types. Most patients did not have a contraindication for anticoagulation. There was no benefit in short-term mortality or risk of PE; there was increased risk of DVT and subsequent bleeding.
- Subjects :
- medicine.medical_specialty
Vena Cava Filters
Clinical Sciences
Inferior vena cava filter
Outcomes
030204 cardiovascular system & hematology
Logistic regression
Inferior vena cava
03 medical and health sciences
0302 clinical medicine
Clinical Research
Neoplasms
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Lung
Contraindication
Cancer
business.industry
Pulmonary embolism
Anticoagulants
Venous Thromboembolism
Hematology
medicine.disease
Surgery
Venous thrombosis
Blood
Good Health and Well Being
Treatment Outcome
Cardiovascular System & Hematology
medicine.vein
Cancer and thrombosis
Deep venous thrombosis
Patient Safety
Radiology
Pulmonary Embolism
business
Venous thromboembolism
Subjects
Details
- ISSN :
- 00493848
- Volume :
- 140
- Database :
- OpenAIRE
- Journal :
- Thrombosis Research
- Accession number :
- edsair.doi.dedup.....15984239ca4660a0c4b14c5f9a57aba5
- Full Text :
- https://doi.org/10.1016/s0049-3848(16)30112-8