0
Pulmonary Vascular Disease |

Trends in Utilization of Inferior Vena Cava Filters and Predictors of Their Use in United States: A Nationwide Study From 2000 to 2009

Shahryar Ahmad; Awani Deshmukh; Amit Taneja; Saqib Baig; Gagan Kumar; Rahul Nanchal
Author and Funding Information

Medical College of Wisconsin, Milwaukee, WI


Chest. 2014;146(4_MeetingAbstracts):834A. doi:10.1378/chest.1995266
Text Size: A A A
Published online

Abstract

SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The role of inferior vena cava (IVC) filters in pulmonary embolism is limited to those with contraindication to/complication of systemic anticoagulation or in those with recurrent pulmonary embolism despite adequate anticoagulation. A recent study in Medicare patients found that the use of IVC filters has been steadily increasing and most of them are not removed. We examined the trends of IVC filter placement in patients admitted with acute pulmonary embolism and identified factors associated with increased use of this procedure

METHODS: We used Nationwide Inpatient Sample (NIS) database from 2000 to 2009 for our study. Pulmonary embolism was identified using ICD-9-CM codes. The use of IVC filters during the admission was identified similarly. We used variance weighted least squares method to compare the trends. We constructed logistic multivariable regression model to examine the patients demographical and hospital characteristics associated with increased use of IVC filter

RESULTS: There were 1,313,021 discharges with primary diagnosis of pulmonary embolism. Of these, 177,472(13.5%) received IVC filter. The total number of IVC filters has increased from 10,818 in 2000 to 22,439 in 2009. However, the proportion of patients with pulmonary embolism receiving IVC filter increased from 2000(12.4%) to 2001(13.3%), but has remained statistically unchanged through 2001 to 2009(13.3%). The variables associated with increased use of IVC filters were - increasing age(OR 1.02;95%CI 1.02-1.02), male gender(OR 1.16;95%CI 1.14-1.19), hispanics(OR 1.25,95%CI 1.20-1.34), teaching hospitals(OR 1.16;95%CI 1.13-1.18). There was significantly lower use of IVC filter in uninsured when compared to private insurance(OR 0.87; 95%CI 0.81-0.94). The odds of use of IVC filter was also lower in Western(OR 0.52; 95%CI 0.50-0.54), Mid West(OR 0.70,95%CI 0.67-0.72) and Southern(OR 0.86;95%CI 0.83-0.89) regions of United States as compared to North Eastern region

CONCLUSIONS: We conclude that while the rate of IVC filter used in pulmonary embolism has remained unchanged from 2001 to 2009, the increased number of IVC filters placed is due to increasing incidence of pulmonary embolism. There are racial, economic and geographical variables which may dictate the use of IVC filters

CLINICAL IMPLICATIONS: There are significant racial, economic and geographical variation is use of IVC filters in United States which needs to be studied further

DISCLOSURE: The following authors have nothing to disclose: Shahryar Ahmad, Awani Deshmukh, Amit Taneja, Saqib Baig, Gagan Kumar, Rahul Nanchal

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543