title: Retrievable inferior vena cava filters in trauma patients: factors that influence removal rate and an argument for institutional protocols.
abstract: BACKGROUND
  Trauma patients at risk for pulmonary embolism, but with contraindications for anticoagulation therapy, often have retrievable inferior vena cava filters (RIVCF) placed. This study evaluated factors associated with the recovery rate of the device (RIVCFs) with the goal of developing an institutional protocol to ensure timely removal.
  
  
  METHODS
  This was a case-control study of 88 trauma patients who underwent RIVCF placement at a level 1 trauma center between 2006 and 2010.
  
  
  RESULTS
  The overall retrieval rate was 58%, declining from 89% in 2006 to 50% in 2009. Factors independently associated with filter nonretrieval included increasing age, increase in number of providers, comorbidity, hospital discharge from the intensive care unit, and discharge to a long-term acute care facility or skilled nursing facility. In 2010, a protocol was implemented and the retrieval rate increased to 73%.
  
  
  CONCLUSIONS
  In a large institution where a number of providers may be responsible for filter management, implementation of a protocol appears to improve retrieval rates.
authors.affiliation: Department of Surgery, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, OK 73104, USA. Roxie-albrecht@ouhsc.edu
authors.forename: Roxie M
authors.initials: RM
authors.lastname: Albrecht
authors.forename: Tabitha
authors.initials: T
authors.lastname: Garwe
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Carter
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Maurer
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002985:Clinical Protocols; D020878:Device Removal / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D058996:Quality Improvement / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014193:Trauma Centers / Q000592:standards*; D016306:Vena Cava Filters; D014947:Wounds and Injuries / Q000150:complications*