Association of Inferior Vena Cava Filter Placement for Venous Thromboembolic Disease and a Contraindication to Anticoagulation With 30-Day Mortality

jamanetwork.com August 7, 2018

After adjustment for immortal time bias, Inferior Vena Cava (IVC) filter placement was associated with increased 30-day mortality in patients with venous thromboembolic disease (VTE) and a contraindication to anticoagulation. Randomized clinical trials are needed to determine the efficacy of IVC filter placement in patients with VTE and a contraindication to anticoagulation. Of 126 030 patients with VTE, 61 281 (48.6%) were male and the mean (SD) age was 66.9 (16.6) years. In this cohort, 45 771 (36.3%) were treated with an IVC filter, whereas 80 259 (63.7%) did not receive a filter. When evaluated in a multivariable Cox model with IVC filter placement analyzed as a time-dependent variable to account for immortal time bias, IVC filter placement was associated with an increased hazard ratio of mortality.