December 12, 2008

Growing Utilization of IVC Filter Placement from 2001-2005: Analysis of NIS

Peter Lee, MD, Akshay Raizada, MD, Rocco Ciocca, MD.
Caritas St. Elizabeth's Medical Center, Boston, MA, USA.

OBJECTIVES: Recent trends in Inferior Vena Cava (IVC) filter placement have demonstrated a significant rise throughout the 1990s. We studied the rate of IVC filter placement and the indications for their use in the United States over a 5-year period from 2001 to 2005.
METHODS: The estimated number of IVC filters placed from 2001 to 2005 was determined based on discharge data from the National Inpatient Sample, a nationwide all-payer inpatient care database that approximates a 20% stratified sample of U.S. hospitals. Both the percentage of IVC filters placed in patients with a diagnosis of Pulmonary Embolism (PE) and/or Deep Vein Thrombosis (DVT), and the percentage of those with PE and/or DVT receiving IVC filters were determined. IVC filter placement and the diagnosis of PE and DVT were based on ICD-9 codes at discharge.
RESULTS: The number of IVC filters placed in hospitalized patients increased from approximately 63,400 to 106,400 between 2001 and 2005. In 2005, diagnoses associated with IVC placement were DVT in 44%, PE (+/- DVT) in 34% and neither DVT or PE in 22%. 12% of patients with DVT had an IVC filter placed, compared to 11% for PE alone and 34% for both PE and DVT. The per capita rate of IVC filter placement continuously increases with age from 0 to 85 years of age. Among patients 0 to 109 years of age, the number of IVC filters placed peaks among 75 to 85 year olds.
CONCLUSIONS: The number of IVC filters placed has continued to increase between 2001 and 2005. The clinical and societal impact of the increased use of IVC filters needs to be closely explored.

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