J Vasc Surg Venous Lymphat Disord. 2022 Mar 5:S2213-333X(22)00096-8. doi: 10.1016/j.jvsv.2022.01.012. Online ahead of print.
ABSTRACT
OBJECTIVE: To evaluate the utility of a published clinical decision support tool to predict the likelihood of a retrievable inferior vena cava (IVC) filter being maintained as a permanent device.
METHODS: This multicenter retrospective cohort study included 1,498 consecutive patients (852 men,646 women; median age 60 years (range 18-98 years) who underwent retrievable IVC filter insertion between 1/2012-12/2019. Indication for IVC filtration, baseline neurologic disease, history of venous thromboembolism(VTE), and underlying malignancy were recorded. Accuracy, sensitivity, and specificity of a published clinical support tool were calculated to determine the utility of the tool.
RESULTS: The majority (1,271/1,498;85%) of filters were placed for VTE with a contraindication to anticoagulation. A history of VTE was present in 811/1,498(54%) patients; underlying malignancy in 531/1,498(35%) patients, and neurological disease in 258/1,498(17%) patients. Of 1,498 filters, 456(30%) were retrieved, 276(18%) filters were maintained as permanent devices on follow-up, and 766 (51%) filters were not retrieved. Accuracy of the clinical prediction model was 61%, sensitivity was 60%, and specificity was 62%.
CONCLUSION: A previously published clinical decision support tool to predict permanence of IVC filters had modest utility in the examined population; this should be taken into account when utilizing this clinical decision support tool outside of the original study population. Future studies are required to refine the predictive capability of IVC filter decision support tools for broader use across different patient populations.
PMID:35259532 | DOI:10.1016/j.jvsv.2022.01.012
