title: A Multicenter Cohort Study of Inferior Vena Cava Filter Use in Children.
abstract: BACKGROUND
  To describe inferior vena cava (IVC) filter use in pediatric patients admitted to U.S. children's hospitals and to determine factors associated with prophylactic placement.
  
  
  METHODS
  This retrospective multicenter cohort study utilized data from the Pediatric Health Information Systems (PHIS) administrative database, with 44 participating children's hospitals. Subjects included for analysis were less than 21 years of age, admitted to a PHIS hospital between January 1, 2004 and December 31, 2012 and had a procedure code for IVC filter placement. ICD-9-CM discharge codes were used to identify subjects with a venous thromboembolism (VTE). Pharmaceutical billing codes were used to identify anticoagulation use.
  
  
  RESULTS
  During this 9-year-study period, 276 subjects met the inclusion criteria. The median age of subjects was 15 years (range 1 month-20 years). Subjects had an ICD-9-CM code for VTE 76% of the time and were started on anticoagulation after IVC filter placement 77% of the time. The mean number of IVC filters placed per year was 6 per 100,000 admissions (SD-1.4), which was constant throughout the study period (P = 0.12). The median number of filters placed by center was 4.5 (range 0-32). In multivariate analysis, subjects undergoing orthopedic surgery were more likely to have prophylactic placement of an IVC filter (OR 4.5; 95%CI 1.8-11).
  
  
  CONCLUSIONS
  IVC filter placement in pediatric patients remains a rare event and is most common in adolescents. Unlike in adults, pediatric IVC filter placement does not appear to be increasing over time and is predominantly used in the setting of a venous thrombotic event.
authors.affiliation: Department of Pediatrics, Hematology and Oncology, Naval Medical Center San Diego, California.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Blevins
authors.affiliation: Divisions of Epidemiology and Nursing, Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
authors.affiliation: Department of Pediatrics, Healthcare Analytics Unit, Children's Hospital of Philadelphia, Pennsylvania.
authors.forename: Yuan-Shung V
authors.initials: YS
authors.lastname: Huang
authors.affiliation: Divisions of Hematology, Departments of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Leslie
authors.initials: L
authors.lastname: Raffini
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Russell T
authors.initials: RT
authors.lastname: Shinohara
authors.affiliation: Divisions of Hematology, Departments of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Char
authors.initials: C
authors.lastname: Witmer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000628:therapy*
keywords: deep venous thrombosis; inferior vena cava filter; pulmonary embolus; venous thromboembolism