National trends in utilization of inferior vena cava filters in the United States, 2000-2009.

Overview

abstract

OBJECTIVE: To characterize national trends over a decade in utilization of inferior vena cava (IVC) filters in the U.S. by year, indication, hospital, and patient demographics. METHODS: Retrospective cross-sectional study utilizing the Nationwide Inpatient Sample Database, 2000 to 2009. IVC filter placement was identified with International Classification of Disease, Ninth Edition codes. Survey weighting, bivariate, and multivariate analysis was performed. RESULTS: The number of IVC filters placed in the U.S. increased by 234% over a decade, from 56,380 in 2000 to 132,049 in 2009. A total of 84.7% of patients had a pulmonary embolism or deep venous thrombosis. A total of 94.6% of IVC filters were placed in urban hospitals. The largest number of IVC filters was placed in the South, followed by the Northeast, Midwest, and Western regions (38.7%, 25.8%, 22.4%, and 13%, respectively). Adjusting for other patient and hospital factors, independent predictors of IVC filter placement were year, hospital size, location, teaching status, patient age group 50 to 79 years, insurance status, and urgency of admission. CONCLUSIONS: The use of IVC filters has dramatically increased over the last decade in the U.S., with variation in utilization based on patient and hospital characteristics. The largest utilization of IVC filters was among patients aged 50 to 79 years, Medicare recipients, and the Southern region of the U.S. The majority of patients receiving IVC filters have a diagnosis of pulmonary embolism or deep venous thrombosis.