Vena Cava Filters in Unstable Elderly Patients with Acute Pulmonary Embolism.

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Vena Cava Filters in Unstable Elderly Patients with Acute Pulmonary Embolism.

Am J Med. 2013 Nov 23;

Authors: Stein PD, Matta F

Abstract
BACKGROUND: Inferior vena cava filters are associated with a reduced in-hospital all-cause case fatality rate of unstable patients with acute pulmonary embolism. Whether vena cava filters are associated with a reduced case fatality rate in adults of all ages with unstable pulmonary embolism, particularly the elderly, has not been determined.
METHODS: Unstable patients with pulmonary embolism (in shock or ventilator dependent) 1999-2008 were identified from the Nationwide Inpatient Sample.
RESULTS: Among 21,095 unstable patients with pulmonary embolism who received thrombolytic therapy, in-hospital all-cause case fatality rate was lower in every age group who received a vena cava filter in addition to thrombolytic therapy (P=0.0012 to <0.0001). Patients aged >81 years showed the greatest absolute reduction of case fatality rate with filters (19.3%). Among 50,210 unstable patients who did not receive thrombolytic therapy, case fatality rate also was lower in every age group who received a vena cava filter (all P<0.0001). Patients aged >81 years with vena cava filters showed the greatest absolute risk reduction of case fatality rate (27.7%).
CONCLUSION: Vena cava filters are associated with a reduced in-hospital all-cause case fatality rate in unstable adults with pulmonary embolism, irrespective of age.

PMID: 24280176 [PubMed - as supplied by publisher]

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