Inferior Vena Cava Filters in Stable Patients with Acute Pulmonary Embolism Who Receive Thrombolytic Therapy

Abstract

BackgroundThere is a need for further analyses of subgroups of patients with pulmonary embolism who might benefit from vena cava filters. In the present investigation, we analyze mortality with vena cava filters in the subgroup of stable patients with pulmonary embolism who received thrombolytic therapy. We use a different database than used previously, and we analyze data in more recent years. MethodsAdministrative data were analyzed from the Premier Healthcare Database, 2010-2014, in hospitalized stable patients with pulmonary embolism who received thrombolytic therapy and may or may not have received a vena cava filter. Patients were identified on the basis of International Classification of Disease, Ninth Revision, Clinical Modification codes. ResultsIn-hospital all-cause mortality in stable patients who received a vena cava filter in addition to thrombolytic therapy was 139 of 2660 (5.2%), compared with 697 of 4332 (16.1%) who did not receive a filter (P < .0001) (relative risk .32). Mortality was lower with a filter every decade of age ≥ 31 years. ConclusionAmong stable patients with acute pulmonary embolism who receive thrombolytic therapy, irrespective of the reason, the additional use of an inferior vena cava filter results in a lower in-hospital mortality.