Severity of disease score as a predictor of mortality after caval filter insertion.
OBJECTIVE
To estimate 30-day mortality after vena caval filter insertion and assess the usefulness of a severity of disease score in predicting postprocedure 30-day survival.


METHODS
Records of 40 consecutive patients undergoing inferior vena caval filter insertion over a 2 1/2-year period were retrospectively reviewed. A severity of illness score for each patient was calculated based on the weighting system described for the APACHE (Acute Physiology and Chronic Health Evaluation) II system. In addition, 30-day postprocedure survival was determined.


RESULTS
Seven patients died within 30 days of the procedure (18%). The use of a severity of disease score of greater than 15 as a predictor of postprocedure 30-day mortality had a sensitivity of 50%, specificity of 97%, positive predictive value of 75%, a negative predictive value of 91.4%, and accuracy of 90%.


CONCLUSIONS
The 30-day mortality after caval filter insertion is significant. A severity of disease score is a useful predictor of patients likely to survive following caval filter insertion. On this basis it may be possible to establish criteria for more beneficial use of vena caval filters.
Department of Radiological Sciences and Diagnostic Imaging, Foothills Hospital, Calgary, Alberta, Canada.
R F
RF
McLoughlin
H
H
Sirkis
C B
CB
So
E L
EL
Raber
J
J
Saliken
R R
RR
Gray
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011655:Pulmonary Embolism / Q000401:mortality / Q000517:prevention & control; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016306:Vena Cava Filters / Q000191:economics