Clinical research studyImpact of Vena Cava Filters on In-hospital Case Fatality Rate from Pulmonary Embolism
Section snippets
Materials and Methods
Patients discharged from short-stay hospitals throughout the United States from 1999 to 2008 with pulmonary embolism, and their in-hospital case fatality rate according to the use of vena cava filters, were identified from the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality.3 Patients with pulmonary embolism were stratified according to whether they were stable or unstable and further stratified according to whether they received
Results
From 1999 to 2008, 2,110,320 patients were discharged from short-stay hospitals in the United States with a diagnosis of pulmonary embolism. Demographic characteristics are listed Table 1 according to the various stratified groups.
Discussion
An impact on case fatality rate with vena cava filters was shown in unstable patients, whether or not they received thrombolytic therapy, and in stable patients who received thrombolytic therapy. Vena cava filters were associated with a lower all-cause in-hospital case fatality rate among unstable patients who received thrombolytic therapy (7.6% vs 18%) and lower all-cause case fatality rate in unstable patients who did not receive thrombolytic therapy (33% vs 51%). The majority of patients,
Conclusions
An impact on in-hospital case fatality rate with vena cava filters was shown in unstable patients, whether or not they received thrombolytic therapy, and in stable patients who received thrombolytic therapy. The majority of hospitalized patients with pulmonary embolism, however, were stable and did not receive thrombolytic therapy. Future prospective study with assessment of the absolute risks of filter placement in various subgroups of patients is warranted to better define in which patients a
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Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.