Vena Cava Filters affect the Mortality Rate of Patients with Pulmonary Embolism

vena caval filter

Statistics reveal that by 2006, almost 92,000 patients with pulmonary embolism had received vena cava filters throughout the United States. In fact, the number of patients who have had inferior vena cava filters inserted in them has been steadily increasing since 1991. However, the efficacy of these filters in all cases of pulmonary embolism has never been clearly established. A recent study, carried out by researchers from the Michigan State University, has for the first time tried to determine the categories of patients suffering from pulmonary embolism who are likely to benefit from the insertion of inferior vena cava filters. The results of the study have been published in a recent issue of the American Journal of Medicine.

The study led by Dr. Paul Stein analyzed more than 2 million patients with pulmonary embolism who received vena cava filters at short-stay hospitals throughout the United States between 1999 and 2008. The data was obtained from the Nationwide Inpatient Sample. The researchers tried to find out the in-hospital all-cause fatality rate according to the use of vena cava filters among the patients. The researchers observed that the in- hospital case fatality rate was marginally lower in stable patients receiving a vena cava filter (7.2% compared to 7.9% in those who did not receive the filter).  In case deep venous thrombosis was discovered in stable patients, vena cava filters did not have any impact on the fatality rate. However, if thrombolytic therapy was also administered in adjunction to vena cava filter in stable patients, there was a definite improvement in the fatality rate (6.4% compared to 15% in those who did not receive thrombolytic therapy along with vena cava filter).  In unstable patients who received both thrombolytic therapy and vena cava filter, there was lower in-hospital case fatality rate (7.6% compared to 18%). Unstable patients who only received vena cava filter also exhibited a lower in-hospital case fatality rate (33% compared to 51%). 

The researchers have opined that giving a vena cava filter to stable patients receiving thrombolytic therapy is justified. Similarly, unstable patients who cannot receive thrombolytic therapy are also likely to benefit from vena cava filters.

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Date: 
Sunday, June 24, 2012