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Inferior Vena Cava Filters in Patients with Acute Pulmonary Embolism and Cancer.
Am J Med. 2017 Nov 10;:
Authors: Stein PD, Matta F, Lawrence FR, Hughes MJ
Abstract
BACKGROUND: Administrative data has shown a lower mortality in hospitalized patients with pulmonary embolism and cancer who receive a vena cava filter. In the absence of a randomized controlled trial of vena cava filters in such patients, further investigation is necessary. Therefore, we performed this investigation using administrative data from a different database than used previously, and we investigate patients hospitalized in more recent years.
METHODS: We analyzed administrative data from the Premier Healthcare Database, 2010-2014, in patients hospitalized with pulmonary embolism and solid malignant tumors. Patients were identified on the basis of International Classification of Disease-9(th) Clinical Modification (ICD-9-CM) codes.
RESULTS: Patients >aged 60 years had a lower in-hospital all-cause mortality with vena cava filters than those who did not have filters, 346 of 4,648 (7.4%) compared with 2,216 of 19,847 (11.2%) (P<0.0001) (relative risk 0.67). Among patients >aged 60 years who received an inferior vena cava, all-cause mortality within 3 months was 704 of 4648 (15.1%) compared with 3444 of 19,847(17.4%) among those who did not receive a filter (P<0.0001) (relative risk 0.86).
CONCLUSION: Elderly patients with pulmonary embolism and cancer may be a special population in whom inferior vena cava filters reduce in-hospital all-cause mortality. Further investigation is needed, particularly in younger patients.
PMID: 29132839 [PubMed - as supplied by publisher]