Cost-effective method for bedside insertion of vena caval filters in trauma patients.
BACKGROUND
The need for patient transport for inferior vena cava (IVC) filter placement impacts patient safety, comfort, charges, and nursing care. Bedside, ultrasound-guided IVC filter placement may offer an acceptable, cost-effective alternative.


METHODS
Prospective cohort study of 55 consecutive trauma patients requiring IVC filter placement. During a 13-month period (August of 1995-September of 1996), patients meeting criteria for IVC filter were evaluated. Complications were recorded, and the potential financial savings were determined.


RESULTS
Of 3,172 trauma admissions, 55 patients met IVC filter criteria and 49 patients had IVC filters placed under ultrasound guidance. In six patients (10.9%), ultrasound guided filter placement failed. There were four complications in four patients (8.2%). Over 13 months, charges were reduced by $69,800 when compared with radiology suite placement and $118,300 when compared with operative placement.


CONCLUSIONS
Ultrasound guided, bedside placement of IVC filters is a safe, cost-effective method of pulmonary embolism prophylaxis in select trauma patients.
Nunn
C R
CR
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37212, USA.
Neuzil
D
D
Naslund
T
T
Bass
J G
JG
Jenkins
J M
JM
Pierce
R
R
Morris
J A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008722:Methods; D008875:Middle Aged; D019095:Point-of-Care Systems; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D014463:Ultrasonography / Q000191:economics; D016306:Vena Cava Filters / Q000191:economics*; D014947:Wounds and Injuries / Q000150:complications / Q000191:economics* / Q000628:therapy