Vena cava filters in hospitalised patients with chronic obstructive pulmonary disease and pulmonary embolism

Author:

Matta Fadi,Stein Paul D.

Abstract

SummaryIn view of the high case fatality rates of patients with chronic obstructive pulmonary disease (COPD) who have pulmonary embolism (PE) we speculated that such patients might benefit from vena cava filters. To test this hypothesis we assessed the database of the Nationwide Inpatient Sample. From 1998–2009, 440,370 patients were hospitalised with PE and COPD who were not in shock or ventilator-dependent and did not receive thrombolytic therapy or pulmonary embolectomy. In-hospital all-cause case fatality rate among those with filters was 5,890 of 68,800 (8.6%) (95% confidence interval [CI] = 8.4–8.8) compared with 38,960 of 371,570 (10.5%) (95% CI = 10.4–10.6) (p<0.0001) who did not receive filters. Case fatality rate was age-dependent. Only those who were older than aged 50 years had a lower in-hospital all-cause case fatality rate with filters. Among such patients, absolute risk reduction was 2.1% (95% CI = 1.9–2.3). The greatest reduction of case fatality rate with vena cava filters was shown in patients >aged 80 years, 11,720 of 81,600 (14.4%) compared with 1,570 of 17,220 (9.1%) (p<0.0001). In conclusion, a somewhat lower in-hospital all-cause case fatality rate was shown with vena filters in stable patients with PE >aged 50 years who also had COPD. The benefit was greatest in elderly patients. The benefit in terms of a decreased case fatality rate would seem to outweigh the risks of vena cava filters in such patients.

Publisher

Georg Thieme Verlag KG

Subject

Hematology

Reference17 articles.

Cited by 16 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Appropriateness guidelines for inferior vena cava filter utilization: A contemporary review;Seminars in Vascular Surgery;2024-06

2. Pulmonary embolism with chronic obstructive pulmonary disease;Chronic Diseases and Translational Medicine;2021-09

3. An expert spotlight on inferior vena cava filters;Expert Review of Hematology;2021-06-23

4.

Management of the COPD Patient with Comorbidities: An Experts Recommendation Document

;International Journal of Chronic Obstructive Pulmonary Disease;2020-05

5. Usefulness of Inferior Vena Cava Filters in Stable Patients with Acute Pulmonary Embolism;The American Journal of Cardiology;2019-06

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