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Inferior Vena Cava Filters in Stable Patients with Acute Pulmonary Embolism Who Receive Thrombolytic Therapy

  • Paul D. Stein
    Correspondence
    Requests for reprints should be addressed to Paul D. Stein, MD, Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, 909 Fee Road, East Lansing, MI 48824.
    Affiliations
    Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Mich
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  • Fadi Matta
    Affiliations
    Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Mich
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  • Mary J. Hughes
    Affiliations
    Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Mich
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      Abstract

      Background

      There is a need for further analyses of subgroups of patients with pulmonary embolism who might benefit from vena cava filters. In the present investigation, we analyze mortality with vena cava filters in the subgroup of stable patients with pulmonary embolism who received thrombolytic therapy. We use a different database than used previously, and we analyze data in more recent years.

      Methods

      Administrative data were analyzed from the Premier Healthcare Database, 2010-2014, in hospitalized stable patients with pulmonary embolism who received thrombolytic therapy and may or may not have received a vena cava filter. Patients were identified on the basis of International Classification of Disease, Ninth Revision, Clinical Modification codes.

      Results

      In-hospital all-cause mortality in stable patients who received a vena cava filter in addition to thrombolytic therapy was 139 of 2660 (5.2%), compared with 697 of 4332 (16.1%) who did not receive a filter (P < .0001) (relative risk .32). Mortality was lower with a filter every decade of age ≥ 31 years.

      Conclusion

      Among stable patients with acute pulmonary embolism who receive thrombolytic therapy, irrespective of the reason, the additional use of an inferior vena cava filter results in a lower in-hospital mortality.

      Keywords

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