IVC filters improve in-hospital mortality rates for patients with congestive heart failure, pulmonary embolism
Inferior vena cava (IVC) filter placement is associated with improved in-hospital mortality rates for patients admitted with congestive heart failure (CHF) and pulmonary embolism (PE), according to a new study published by the American Journal of Roentgenology.
“Although routine use of IVC filters for PE in patients with preexisting CHF is not recommended, given the adverse physiologic effects of PE on cardiac function in patients with preexisting CHF, we hypothesized that IVC filter placement would be associated with reduced in-hospital mortality in patients admitted with CHF and PE and used a large administrative database to test this hypothesis,” wrote author Vibhor Wadhwa, MD, department of radiology at the University of Arkansas for Medical Sciences in Little Rock, Arkansas, and colleagues.
The authors examined data from the 2005-2015 Nationwide Inpatient Sample for more than 425,000 patients admitted with both CHF and PE. The all-cause in-hospital mortality rate for patients who received an IVC filter was 9.7 percent, while the rate for patients who did not receive an IVC filter was 12.2 percent.
“In patients with comorbidity of CHF who were admitted with PE, IVC filter placement was associated with lower all-cause in-hospital mortality,” the authors wrote. “In the absence of data from randomized controlled trials, the results of this study suggest survival benefit with IVC filter placement in patients with PE and CHF.”
Wadhwa and colleagues noted that IVC filters often create their own issues, something providers must be aware of at all times.
“Because the national filter retrieval rate is low, most patients receiving IVC filters would presumably keep the filters for a long time,” Wadhwa wrote. “This may be necessary in patients with ongoing risk of recurrent PE. However, this extended period also places these patients at risk of complications associated with filters. Thus, appropriate patient selection is imperative when considering filter placement.”
The authors also explained that their study had some noteworthy limitations, including the chance of results being affected by coding errors. In addition, they added, the exact time of IVC filter placement during each patient’s hospitalization was unknown.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.