Timing of Prophylactic Inferior Vena Cava Filter Placement and Trauma Outcomes

Abstract

Background Prophylactic inferior vena cava filters (IVCFs) are often placed in trauma patients who cannot receive prophylactic anticoagulation. IVCFs are utilized in an effort to reduce the risk of acute pulmonary embolism (PE) and mortality. This study aims to investigate whether time-to-filter placement is associated with differences in trauma outcomes. Methods We conducted a single-center retrospective review of adult trauma patients who underwent prophylactic IVCF placement. Patients were divided into 2 groups based on time-to-filter: 0-48 hours and >48 hours. Outcome measures included post-filter deep vein thrombosis (DVT), post-filter PE, in-hospital mortality, and ICU length of stay (ICU-LOS). Significance was defined as P < .05. Results During the 6-year study period, 513 patients underwent prophylactic IVCF placement. Both groups were similar with respect to injury severity score (ISS) ( P = .540), percent of patients on home anticoagulation (38% and 39%, P = .845), abbreviated injury scale (AIS) by anatomic region ( P = .899), and traumatic brain injury (TBI) prevalence ( P = .182). Time-to-filter was not associated with significant differences in DVT, PE, or in-hospital mortality ( P > .05 for all). Filter placement in the first 48 hours was associated with shorter ICU-LOS and hospital-LOS. Conclusions Currently, there are no investigations in the trauma literature looking at the impact of time-to-filter on complications related to venous thromboembolism and potential survival benefit. Results of this investigation showed that IVCF placement within the first 48 hours was significantly associated with shorter ICU- and hospital- LOS.