Prophylactic Inferior Vena Cava Filters in Trauma: A National Survey of Current Practice

Abstract

A standardised telephone and electronic questionnaire survey was constructed to ascertain current practice in major trauma centres in England regarding the use of inferior vena cava (IVC) filters as thromboprophylaxis in the management of multiply injured patients. The leads for trauma or duty consultants of each of the 22 major trauma centres in England were contacted, with a response rate of 100%. Eight of the 22 units (37%) used prophylactic IVC filters in major trauma patients, and all of these were inserted by a radiologist and designed to be retrievable. Only five units surveyed (18%) were aware of guidance regarding the use of IVC filters. Reported complication rates were low, but only two centres reported no complications. There was no consensus for the time frame for removal of IVC filters. Patients with prolonged immobility secondary to spinal injury or head injury and those with pelvic injuries were considered to be at the highest risk. These results show that there is considerable variation among clinicians who manage multiply injured patients. There is a low level of awareness of international guidelines. This is likely to reflect the paucity of evidence supporting their use.