Use of Vena Cava Filter Varies Widely Among Hospitals
(HealthDay News) – The frequency of vena cava filter (VCF) use in patients with acute venous thromboembolism (VTE) varies widely and depends primarily on hospital practice, even after adjustment for clinical and socioeconomic factors, according to research published online March 18 in JAMA Internal Medicine.
Richard White, MD, of the University of California, Davis, School of Medicine in Sacramento, and colleagues conducted a retrospective observational study using administrative hospital data to compare the frequency of use of VCF among 263 California hospitals between January 2006 and December 2010.
According to the researchers, there was an exceptionally wide range in the frequency of VCF use among the hospitals, from 0–38.96% of all acute VTE hospitalizations. As expected, the significant clinical predictors of VCF use were acute bleeding at the time of admission, a major operation after admission for VTE, presence of metastatic cancer, and extreme severity of illness. However, VCFs were used more frequently than expected in 109 hospitals and less frequently in 59 hospitals. Hospital characteristics associated with VCF use included a small number of beds, a rural location, and other private vs. Kaiser hospitals. Use of VCFs was noted to vary widely even within geographically proximate areas.
"Taken together with the results of another recent study that reported no clear indication for VCF use in approximately 50 percent of patients who received a VCF, the findings suggest that use of VCFs is based substantially on the local hospital culture and practice patterns," the authors conclude.