Zoltowska Dominika M, Thind Guramrinder S, Agrawal Yashwant, Kalavakunta Jagadeesh K, Joseph Soji, Patri Sandeep
Department of Internal Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, MI, United States.
Department of Cardiology, St. Joseph Mercy Oakland, Pontiac, MI 48341, United States.
Rev Recent Clin Trials. 2018;13(4):305-311. doi: 10.2174/1574887113666180626161130.
There have been increasing concerns regarding inappropriate usage of vena caval filters. Our study was done to analyze the current trends in vena caval filter placement.
This study used the data from Nationwide Inpatient Sample database for the years 2002- 2012 to identify patients with vena caval filter placement. Trends in both therapeutic and prophylactic vena caval filter use over the eleven years' period were analyzed. Multiple simple logistic regression model was used to assess trends.
The overall incidence of vena caval filter placement increased from 2002 to 2012. The odds of vena caval filter placement in 2012 were 1.340 (95% CI: 1.236, 1.453) times the odds of vena caval filter placement in 2002. However, a downward trend was observed after the year 2010. The odds of vena caval filter placement in 2012 were 0.854 (95% CI: 0.801, 0.911) times the odds in 2010. Similar trends were seen in both therapeutic and prophylactic placements. The proportion of prophylactic vena caval filter placements with indications of morbid obesity (P<0.0001), head injury (P=0.0007), surgery of the eye, brain, spine or other major surgery (P<0.0001) hemorrhage/bleeding (P=0.0046) significantly increased in 2012 when compared to 2002.
Vena caval filter placement rates have increased significantly from 2002 to 2012 for both prophylactic and therapeutic indications. However, there seems to be downward trend when comparing 2012 to 2010. Measures such as physician education and hospital audits can be done to further bring down inappropriate vena caval filter placements.
对于下腔静脉滤器的不当使用，人们越来越担忧。我们开展这项研究以分析下腔静脉滤器置入的当前趋势。
本研究使用了2002年至2012年全国住院患者样本数据库的数据，以识别接受下腔静脉滤器置入的患者。分析了11年间治疗性和预防性下腔静脉滤器使用的趋势。使用多个简单逻辑回归模型来评估趋势。
2002年至2012年，下腔静脉滤器置入的总体发生率有所上升。2012年下腔静脉滤器置入的几率是2002年的1.340倍（95%置信区间：1.236, 1.453）。然而，2010年后观察到下降趋势。2012年下腔静脉滤器置入的几率是2010年的0.854倍（95%置信区间：0.801, 0.911）。治疗性和预防性置入均呈现类似趋势。与2002年相比，2012年有病态肥胖指征（P<0.0001）、头部损伤（P=0.0007）、眼、脑、脊柱手术或其他大手术（P<0.0001）、出血/出血倾向（P=0.0046）的预防性下腔静脉滤器置入比例显著增加。
2002年至2012年，无论是预防性还是治疗性指征，下腔静脉滤器置入率均显著上升。然而，将2012年与2010年相比似乎有下降趋势。可以采取诸如医生教育和医院审核等措施，以进一步降低下腔静脉滤器的不当置入情况。
