Hospital Fray Bernardino Alvarez, Ciudad de México, México.

Background Since the introduction of the filter, consensus over the indications for using a vena cava filter (VCF) in trauma patients has been iffy. The use of VCF in trauma patients has altered as VCF technology and practise guidelines have advanced. The positioning of VCF varies amongst trauma centres, according to this study. Resources and techniques With the help of information from the National Trauma Data Bank, a retrospective analysis was conducted (2005-2014). Trauma facilities were divided into groups based on whether they used VCFs during the research period (VCF+/VCF). To forecast the quantity of VCFs utilised by the VCF+ centres, a multivariable probit regression model was fitted (the expected [E] number of VCF per center). To assess interfacility practise variance, the ratio of observed VCF placement (O) to predicted VCFs (O:E) was computed and rank sorted. Results 448 centres in all placed 65,482 VCFs. 20 centres (4.3%) did not place any VCFs. Deep vein thrombosis, spinal cord paralysis, and major operation were the best indicators of VCF insertion. Admission in 2014 was the most unfavourable predictor of VCF placement. The variation in O:E among the VCF+ centres was around 500%. An O:E larger than one was present in 150 centres. A O:E of less than one was present in 169 centres. Conclusions The practise of placing VCFs varies significantly. This difference can be attributed to a variety of factors, including contradicting recommendations, evolving scientific knowledge, declining payment rates, the culture of trauma centres, and the characteristics of the patients treated at these facilities.

Vena cava filter, Trauma center, Practice pattern, NTDB

Damela San Martín. Vena Cava Filter Use Practice Variation Among Trauma Centers in the National Trauma Database. Insights Journal of Surgery and Clinical Case Reports 2020.