A five-year, retrospective, comparison review of survival in neurosurgical patients diagnosed with venous thromboembolism and treated with either inferior vena cava filters or anticoagulants.
Publication/Presentation Date
12-1-2007
Abstract
BACKGROUND: [corrected] The optimal role of inferior vena cava filters (IVCF) in the management of venous thromboembolism (VTE) is not well defined. The purpose of this study was to compare mortality risk for VTE patients treated with IVCF or anticoagulants.
METHODS: Analyses were based on data from 175 VTE patients, who had concurrent conditions of central nervous system (CNS) cancer or brain hemorrhage, and who were seen at Thomas Jefferson University Hospital between 1998 and 2002. Patients who received filters (n = 136) and those who were treated with anticoagulants only (n = 39) were compared on in-hospital mortality via logistic regression and on overall mortality via survival analyses methods.
RESULTS: A total of 17 study patients (9.7%) died in-hospital. After controlling for patient sociodemographic, medical, and treatment characteristics, the filter group had a 65% reduction of risk compared to the anticoagulant group (adjusted odds ratio, OR = 0.36, P = 0.138). Age, renal disease, and ventriculoperitoneal shunt/ventriculostomy were independent predictors of higher in-hospital mortality. A total of 128 deaths (73.1%) were recorded during the study's entire follow-up period. Unadjusted median survival was 21 weeks for the filter group and 11 weeks for the anticoagulant group (P = 0.177). In adjusted analyses, the filter group had a 28% reduction of risk compared to the anticoagulant group (adjusted hazard ratio, HR = 0.72, P = 0.181). Caucasian race and CNS cancer were independent predictors of higher overall mortality.
CONCLUSIONS: Neither in-hospital nor overall mortality differences between the two treatment groups was significant, although we found some indication of a beneficial effect of filter placement with respect to short-term, in-hospital survival.
Volume
24
Issue
3
First Page
247
Last Page
254
ISSN
0929-5305
Published In/Presented At
Ghanim, A. J., Daskalakis, C., Eschelman, D. J., & Kraft, W. K. (2007). A five-year, retrospective, comparison review of survival in neurosurgical patients diagnosed with venous thromboembolism and treated with either inferior vena cava filters or anticoagulants. Journal of thrombosis and thrombolysis, 24(3), 247–254. https://doi.org/10.1007/s11239-007-0025-9
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
17385008
Department(s)
Administration and Leadership
Document Type
Article