The University of California San Francisco School of Medicine, San Francisco, CA, USA.
J Gen Intern Med. 2010 Apr;25(4):321-5. doi: 10.1007/s11606-009-1227-y. Epub 2010 Jan 20.
Use of inferior vena cava (IVC) filters has been increasing over time. However, because of the increased risk of deep vein thrombosis with permanent filters, placement of retrievable filters has been recommended. Little is known about the factors associated with planned retrieval of IVC filters.
To describe rates and predictors of plans to retrieve IVC filters in hospitalized patients.
We identified all IVC filter placements from 2001-2006 at an academic medical center and reviewed medical charts to obtain data about patient characteristics, filter retrieval plans, and retrieval success rates. Multivariable logistic regression was used to identify independent predictors of planned filter retrieval in patients with retrievable filters.
Out of 240 patients who underwent placement of retrievable IVC filters, only 73 (30.4%) had documented plans for filter retrieval. Factors associated with lower rates of planned filter retrieval included a history of cancer [adjusted odds ratio (OR) and 95% confidence interval 0.2 (0.1-0.5)] and not being discharged on anticoagulants [OR 0.1 (0.1-0.3)]. In addition, 36 (21.6%) of patients without retrieval plans had no contraindications to retrieval. Of the 62 patients who underwent attempted filter retrieval, 25.8% of filters could not be successfully removed.
Only 30.4% of patients who underwent placement of a retrievable IVC filter had documented plans for filter removal. Although most patients had justifiable reasons for filter retention, 21.6% of patients had no clear contraindications to filter removal. Efforts to improve rates of filter retrieval in appropriate patients may help reduce the long-term complications of IVC filters.
下腔静脉滤器（IVC）的使用随着时间的推移而增加。然而，由于永久性滤器导致深静脉血栓形成的风险增加，因此建议使用可回收滤器。关于与 IVC 滤器计划回收相关的因素知之甚少。
描述住院患者计划回收 IVC 滤器的比率和预测因素。
我们在一家学术医疗中心确定了 2001-2006 年所有的 IVC 滤器放置，并回顾了病历以获取有关患者特征、滤器回收计划和回收成功率的数据。使用多变量逻辑回归来确定可回收滤器患者中计划滤器回收的独立预测因素。
在接受可回收 IVC 滤器放置的 240 名患者中，只有 73 名（30.4%）有记录的滤器回收计划。与计划滤器回收率较低相关的因素包括癌症史[校正后的优势比（OR）和 95%置信区间 0.2（0.1-0.5）]和未接受抗凝治疗出院[OR 0.1（0.1-0.3）]。此外，36 名（21.6%）无回收计划的患者没有回收的禁忌症。在 62 名尝试进行滤器回收的患者中，有 25.8%的滤器无法成功取出。
只有 30.4%接受可回收 IVC 滤器放置的患者有记录的滤器移除计划。尽管大多数患者有合理的保留滤器的理由，但 21.6%的患者没有明确的滤器移除禁忌症。努力提高适当患者的滤器回收率可能有助于减少 IVC 滤器的长期并发症。
