Nuffer Zachary, Ramis Phil, Rohren Eric M, Horn Gary
Department of Radiology, Baylor College of Medicine, Baylor St. Luke's Medical Center, 1101 Bates Ave., Houston, TX 77030, USA.
Radiology Partners Research Institute, 2330 Utah Avenue Suite 200, El Segundo, CA 90245, USA.
J Clin Med. 2025 Jun 7;14(12):4034. doi: 10.3390/jcm14124034.
: Inferior vena cava (IVC) filters are used to prevent pulmonary embolism (PE) in patients with contraindications to anticoagulation, among other indications. Despite clinical guidelines recommending timely retrieval, rates remain suboptimal, raising concerns about long-term complications. This study examines national hospital-level variation in IVC filter retrieval rates and adherence to timing recommendations. : A retrospective analysis was conducted using data from 12,197 patients across 158 U.S. facilities between 1 January 2020, and 29 August 2024. Retrieval rates, time to retrieval, and associations with facility-specific factors such as procedural volume and academic affiliation were evaluated using descriptive statistics and correlation analyses. : Facility retrieval rates varied widely, ranging from 0.36% to 100%, with a mean of 23% (SD 24%). Only 43% (SD 12%) of filters were retrieved within 90 days, as recommended. A weak negative correlation was observed between retrieval rate and procedure volume (r = -0.24), as well as patient age (r = -0.17). Several high-volume facilities showed potential guideline non-adherence, placing many filters but retrieving few. No significant differences were found between academic and non-academic institutions in retrieval rate or timing. : Substantial variability exists in IVC filter retrieval practices, and many facilities fall short of timely removal benchmarks. These findings highlight the need for targeted quality improvement initiatives to increase retrieval adherence, reduce filter-related complications, and improve patient outcomes.
下腔静脉(IVC)滤器用于预防抗凝治疗有禁忌证的患者发生肺栓塞(PE)等情况。尽管临床指南建议及时取出滤器,但取出率仍不理想,引发了人们对长期并发症的担忧。本研究调查了全国医院层面下腔静脉滤器取出率的差异以及对时间建议的遵循情况。
采用回顾性分析方法,使用了2020年1月1日至2024年8月29日期间美国158家医疗机构中12,197名患者的数据。通过描述性统计和相关性分析评估取出率、取出时间以及与特定机构因素(如手术量和学术附属关系)之间的关联。
各机构的取出率差异很大,从0.36%到100%不等,平均为23%(标准差24%)。按照建议,只有43%(标准差12%)的滤器在90天内取出。取出率与手术量(r = -0.24)以及患者年龄(r = -0.17)之间存在微弱的负相关。几家手术量大的机构显示出可能未遵循指南,放置了许多滤器但取出很少。学术机构和非学术机构在取出率或时间方面未发现显著差异。
下腔静脉滤器取出实践存在很大差异,许多机构未达到及时取出的标准。这些发现凸显了需要有针对性的质量改进措施,以提高取出的依从性,减少与滤器相关的并发症,并改善患者预后。