Prophylactic vena cava filter insertion in selected high-risk orthopaedic trauma patients.
J Orthop Trauma
; 11(4): 267-72, 1997 May.
Article
en En
| MEDLINE
| ID: mdl-9258824
ABSTRACT
OBJECTIVES:
(a) To determine the incidence and risk factors for the development of pulmonary embolism in orthopaedic trauma patients and (b) to determine whether prophylactic vena cava filters are efficacious against pulmonary edema in high-risk patients. DESIGNS Before and after trial on the incidence of pulmonary embolism in the orthopaedic trauma population before and after the introduction of prophylactic vena cava filters.SETTING:
Tertiary care level I trauma center. PATIENTS Thirty-five patients received prophylactic vena cava filters. These patients had a long bone and pelvic, multiple long bone fractures, or a complex (Kane's III or IV) pelvic fracture with at least one additional risk-factor at an age of > 55 years and an Injury Severity Score of > 16 or requiring prolonged (> 6 weeks) immobilization. INTERVENTION Thirty-five patients had vena cava filters placed (32 titanium Greenfield filters, Medi-tech/Boston Scientific, Watertown, MA; and three Bird's Nest filters, Cook Bloomington, IN). Most filters (n = 33) were placed percutaneously in radiology. MAIN OUTCOMEMEASURES:
(a) Morbidity related to filter insertion, (b) incidence of pulmonary embolism in orthopaedic trauma population compared with historical controls who did not receive filters, and (c) patency of filters. RESULTS ANDCONCLUSIONS:
Minimal morbidity was related to prophylactic vena cava filter insertion. There was a significant (p < 0.04); (Fisher's exact) decrease in the incidence of pulmonary embolism in the orthopaedic trauma population as a whole after the use of prophylactic vena cava filters. Follow-up ultrasound showed a 1 and 2-year inferior vena cava patency rate of 93.6% +/- 6.2% by life table analysis. We conclude that selected use of prophylactic vena cava filters in orthopaedic trauma is safe and decreases the incidence of pulmonary embolism.
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Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Embolia Pulmonar
/
Filtros de Vena Cava
/
Fracturas Óseas
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Humans
/
Middle aged
Idioma:
En
Revista:
J Orthop Trauma
Asunto de la revista:
ORTOPEDIA
/
TRAUMATOLOGIA
Año:
1997
Tipo del documento:
Article
País de afiliación:
Estados Unidos