Inferior vena cava filters reduce mortality in elderly patients with pulmonary embolism, cancer
Elderly patients with pulmonary embolism and cancer seem to benefit from inferior vena cava filters, which reduce in-hospital and 3-month all-cause mortality, according to a study.
In-hospital all-cause mortality was lower among patients aged >60 years with vena cava filters than those without filters (7.4 percent vs 11.2 percent; relative risk [RR], 0.67; p<0.0001). Patients aged >60 years who received vena cava filters also had a lower all-cause mortality within 3 months compared with those who did not receive a filter (15.2 percent vs 17.4 percent; RR, 0.86; p<0.0001).
“Further investigation is needed, particularly in younger patients,” the investigators said.
Analysis was carried out using administrative data from the Premier Healthcare Database, 2010–2014, in patients hospitalized with pulmonary embolism and solid malignant tumours. The International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify patients.
“Administrative data have shown a lower mortality in hospitalized patients with pulmonary embolism and cancer who receive a vena cava filter. In the absence of a randomized controlled trial of vena cava filters in such patients, further investigation is necessary,” the investigators noted.
In a subgroup analysis of the same study, results showed that the additional use of an inferior vena cava filter reduced in-hospital mortality among stable patients with acute pulmonary embolism receiving thrombolytic therapy. [Am J Med 2018;131:97-99]
These findings support those of a 2012 study, which concluded that inferior vena cava filter is a safe and effective method for pulmonary thromboembolism prophylaxis, especially for patients with high bleeding risk and who cannot be anticoagulated. [Turk Neurosurg 2012;22:269-273]