Do the benefits of prophylactic inferior vena cava filters outweigh the risks in trauma patients? A meta-analysis*

Mahir Gachabayov, Lulejeta A. Latifi, Rifat Latifi

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: The aim of this systematic review and meta-analysis was to evaluate whether the benefits of prophylactic inferior vena cava filters (IVCF) outweigh the risks thereof. Patients and methods: PubMed, EMBASE, and Cochrane Library were systematically searched for records published from 1980 to 2018 by two independent researchers (MG, GG). The endpoints of interest were pulmonary embolism (PE) and deep vein thrombosis (DVT) rates. Quality assessment, data extraction and analysis were performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Mantel–Haenszel method with odds ratio and 95% confidence interval (OR (95%CI)) as the measure of effect size was utilized for meta-analysis. Results: Fifteen studies (two randomized controlled trials and 13 observational studies) were included in the meta-analysis. PE rate was 0.9% (11/1183) in IVCF vs. 0.6% (240/39,417) in No IVCF. This difference was not statistically significant [OR (95%CI) = 0.31 (0.06, 1.51); p = 0.15]. DVT rate was 8.4% (77/915) in IVCF vs. 1.7% (653/38,807) in No IVCF. The difference was not statistically significant [OR (95%CI) = 2.67 (0.90, 7.98); p = 0.08]. In the subset of RCTs, PE rate was 0% (0/64) in IVCF vs. 12% (6/5) in No IVCF. This difference was statistically significant [OR (95%CI) = 0.12 (0.01, 1.03); p = 0.05]. Conclusions: This meta-analysis found that prophylactic IVCF may be associated with decreased PE rates at the possible cost of increased DVT rates. Further observational and experimental clinical studies are needed to confirm the findings of this meta-analysis.

Original languageEnglish (US)
JournalActa Chirurgica Belgica
DOIs
StateAccepted/In press - 2022
Externally publishedYes

Keywords

  • deep vein thrombosis
  • inferior vena cava
  • inferior vena cava filter
  • pulmonary embolism
  • Trauma

ASJC Scopus subject areas

  • Surgery

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