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Integrative Trauma and Emergency Medicine


Research Article

The Effectiveness of Prophylactic Inferior Vena Cava Filter Insertion in Trauma Patients

Sultan Al Amri, Eidah Althomali, Adnan Alzaharani, Ashraf Shaban, Mohamed Elmasry, Mohamed Tharwat, Mohamad Elghonimy, Mohamed Abd Elrahman, Mohamed Rabee

Correspondence Address :

Dr. Sultan Al Amri
Consultant intensivist
Department of ICU
Care National Hospital
Riyadh KSA, Saudi Arabia P.O 2715
Tel: +966536066615

Received on: May 17, 2018, Accepted on: June 06, 2018, Published on: June 15, 2018

Citation: Sultan Al Amri, Eidah Althomali, Adnan Alzaharani, et al. (2018). The Effectiveness of Prophylactic Inferior Vena Cava Filter Insertion in Trauma Patients

Copyright: 2018 Sultan Al Amri, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Background/objective: Patients with trauma are at risk for venous thromboembolism, such as deep venous thrombosis and pulmonary embolisms (PEs), and using inferior vena cava (IVC) filters or anticoagulants may decrease the risks. This study aims to
compare the effectiveness of the prophylactic insertion of IVC filters in patients with femur or pelvic fractures and to determine if the IVC filter insertion, combined with prophylactic anticoagulation, is superior to prophylactic anticoagulation use in preventing thromboembolic events in trauma patients.
Methods: This is an observational comparative study. The enrolled patients were observed for the development of PEs, and those who had an IVC filter inserted and those who didn't have IVC filter inserted were compared; in relation to the development of PE and death. The study was conducted between April 2015 and October 2016 among 36 trauma patients at Care National Hospital in Riyadh, Saudi Arabia. Thirty six patients were admitted to the intensive care unit (ICU) with pelvic or femur fractures. The patients were selected using the convenience sampling technique. Data were analysed using SPSS version 22; as a descriptive analysis and chi-square test for comparison.
Results: A total of 36 patients were admitted to the ICU during the study period. The mean patients' age was 34 +/- 10 years, and all ICU admissions were males. The mode of trauma was attributed to; road traffic accidents (RTA) 83.3%, falls from a varying heights 13.9%, and gunshots 2.8%. The patients with trauma were classified into three types according to the area of the fractures: pelvic fractures in 19 (52.8%), femur fractures in 15 (41.7%), and long bone fracture in 15 (41.7%), where10 (27.8%) had two fractures in and 1(2.8%) had three. Thirty patients had IVC filters (83.3%), and none of them were positive for a PE (p = 0.02). Among 24 patients who used anticoagulants, PE was only reported in 1 (4.2%; p = 0.6); 3 patients died during the study but only one died of major PE, and this patient had started anticoagulation but had no IVC filters inserted; the second died due to septic shock and severe acute respiratory distress syndrome (ARDS); and the last one died despite being enrolled in study. This participant died only after one day of admission and without starting an anticoagulant or having an IVC filter inserted.
Conclusion: Trauma patients are at risk of thromboembolic episodes. Early insertion of an IVC filter along with prophylactic anticoagulation prevented the development of PE.

Keywords: IVC filters (inferior vena cava fi lters), PE (pulmonary embolism), DVT (deep venous thrombosis), Trauma