Stein PD, et al. - Researchers sought to investigate the mortality reducing efficacy, if any, of inferior vena cava (IVC) filters in unstable patients (in shock or on ventilator support) with acute pulmonary embolism and in stable patients undergoing surgical pulmonary embolectomy. Based on the findings of this study, in concert with previous retrospective data, it was concluded that an IVC filter may be useful in these patient populations.

Methods

• Researchers analyzed administrative data from the Premier Healthcare Database, 2010-2014.
• In patients who had none of the comorbid conditions listed in the Charlson Comorbidity Index, mortality was assumed to be due to pulmonary embolism.
• On the basis of International Classification of Disease-9thClinical Modification (ICD-9-CM) codes, data were determined.

Results

• Findings demonstrated that all-cause mortality among unstable patients was lower with IVC filters in-hospital, 288 of 1972 (23%) vs 1344 of 3012 (45%)(P<0.0001) and 3-months after discharge, was 316 of 1272 (25%) vs 1428 of 3002 (48%) (P<0.0001).
• Researchers found that mortality attributable to pulmonary embolism was lower with IVC filters in unstable patients in-hospital, 191 of 926 (21%) vs 913 of 2138 (43%)(P<0.0001) and at 3 months, 215 of 926 (23%) compared with 971 of 2138 (45%)(P<0.0001).
• Data reported a lower all-cause mortality with IVC filters instable patients who underwent pulmonary embolectomy while in-hospital, 20 of 245 (8.2%) vs 49 of 124 (40%)(P <0.0001) and at 3 months, 21 of 245 (8.6%) vs 49 of 124 (40%)(P<0.0001).
• In addition, it was noted that with IVC filters, mortality ascribed to pulmonary embolism was lower, in stable patients who underwent pulmonary embolectomy while in-hospital, 2 of 211 (0.9%) vs 38 of 105 (36%)(P<0.0001) and at 3 months, 3 of 211 (1.4%) vs 38 of 105 (36%)(P<0.0001).