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.
McLoughlin
R F
RF
Department of Radiological Sciences and Diagnostic Imaging, Foothills Hospital, Calgary, Alberta, Canada.
Sirkis
H
H
So
C B
CB
Raber
E L
EL
Saliken
J
J
Gray
R R
RR
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