Journal article
Venous thrombotic, thromboembolic, and mechanical complications after retrievable inferior vena cava filters for major trauma
British Journal of Anaesthesia, Vol.114(1), pp.63-69
2015
Abstract
Background The ideal thromboprophylaxis in patients at risk of bleeding is uncertain. This retrospective cohort study assessed the risk factors for complications after using retrievable inferior vena cava (IVC) filters for primary or secondary thromboembolism prophylaxis in patients after major trauma. Methods Using data from radiology, trauma and death registries, the incidence of and risk factors for subsequent deep venous thrombosis (DVT), venous thromboembolism (VTE), and mechanical complications related to retrievable IVC filters in patients, admitted between 2007 and 2012, were assessed in a single trauma centre. Results Of the 2940 major trauma patients admitted during the study period, a retrievable IVC filter was used in 223 patients (7.6%). Thirty-six patients (16%) developed DVT or VTE subsequent to placement of IVC filters (median 20 days, interquartile range 9-33), including 27 with lower limb (DVT), 8 upper limb DVT, and 4 pulmonary embolism. A high Injury Severity Score, tibial/fibular fractures, and a delay in initiating pharmacological thromboprophylaxis after insertion of the filters (14 vs 7 days, P=0.001) were significant risk factors. Thirty patients were lost to follow-up (13%) and their filters were not retrieved. Mechanical complications - including filters adherent to the wall of IVC (4.9%), IVC thrombus (4.0%), and displaced or tilted filters (2.2%) - were common when the filters were left in situ for >50 days. Conclusions A delay in initiating pharmacological thromboprophylaxis or filter removal were associated with an increased risk of subsequent DVT, VTE, and mechanical complications of retrievable IVC filters in patients after major trauma.
Details
- Title
- Venous thrombotic, thromboembolic, and mechanical complications after retrievable inferior vena cava filters for major trauma
- Authors/Creators
- K.M. Ho (Author/Creator) - Royal Perth HospitalJ.A. Tan (Author/Creator) - Royal Perth HospitalM. Burrell (Author/Creator) - Royal Perth HospitalS. Rao (Author/Creator) - Royal Perth HospitalP. Misur (Author/Creator) - Royal Perth Hospital
- Publication Details
- British Journal of Anaesthesia, Vol.114(1), pp.63-69
- Publisher
- Oxford University Press
- Identifiers
- 991005540572107891
- Copyright
- © The Author 2014.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.75 Blood Clotting
- 1.75.271 Venous Thromboembolism
- Web Of Science research areas
- Anesthesiology
- ESI research areas
- Clinical Medicine