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Abstract

Introduction: Inferior vena cava filters (IVCF) are often inserted for pulmonary embolism prevention in the high risk trauma population. The Eastern Association for the Surgery of Trauma has established practice management guidelines for the high risk trauma population. The purpose of this study was to identify in-hospital PE complications high risk trauma patients who underwent IVCF insertion during a 10-year period. Methods: During the 10-year period from 1/02-12/12, guidelines for prophylactic IVCF insertion were adhered to in the management of high risk trauma patients. Patients with severe closed head injury, spinal cord injury, complex pelvic fractures and multiple long bone fractures had IVCFs inserted. IVCFs were inserted in pelvic fracture patients and long bone fracture patients when relegated to prolonged non-weight bearing status. All in-patient data were collected retrospectively from the 10-year period. Results: 453 patients received prophylactic IVCFs during the study period. Average age of the study population was 35.9 years. Risk factor indicators were: Pelvic fracture (188), long bone fractures (191), severe traumatic brain injury (133), and spinal cord injury (42). 101 patients had greater than one risk factor. The average hospital day for IVCF insertion was day 7 (R: 2–48) and average hospital length of stay was 28 days (R: 3–183). Ten patients were diagnosed with PE, 8 (80%) of which occurred prior to IVCF insertion. Two patients developed PE post IVCF insertion. There were no deaths secondary to PE in the high risk population during the 10-year period. Conclusions: Prophylactic IVCF insertion in the high risk trauma population decreases complications and mortality secondary to pulmonary embolism. Early recognition of these risk factors and early IVCF insertion may enhance pulmonary embolism prevention and improve mortality rate.