Stein Paul D, Matta Fadi, Hughes Mary J
Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Mich.
Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Mich.
Am J Med. 2018 Jan;131(1):97-99. doi: 10.1016/j.amjmed.2017.07.028. Epub 2017 Aug 12.
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.
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.
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.
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.
有必要进一步分析可能从腔静脉滤器中获益的肺栓塞患者亚组。在本研究中，我们分析了接受溶栓治疗的稳定型肺栓塞患者亚组中使用腔静脉滤器的死亡率。我们使用了与之前不同的数据库，并分析了最近几年的数据。
对2010 - 2014年Premier医疗数据库中的管理数据进行分析，纳入接受溶栓治疗且可能接受或未接受腔静脉滤器的住院稳定型肺栓塞患者。根据国际疾病分类第九版临床修订本代码识别患者。
除溶栓治疗外还接受腔静脉滤器的稳定型患者的院内全因死亡率为2660例中的139例（5.2%），未接受滤器的4332例中的697例（16.1%）（P <.0001）（相对风险0.32）。年龄≥31岁的每十年，使用滤器的死亡率更低。
在接受溶栓治疗的急性肺栓塞稳定型患者中，无论原因如何，额外使用下腔静脉滤器可降低院内死亡率。
