Out of Sight, out of Mind? An Audit Which Proposes a Follow-Up and Management Pathway for Inferior Vena Cava Filters.
Insertion of an IVC filter can be a safe and effective way to avoid PE in thrombosis patients who cannot be anticoagulated. If temporary filters are not promptly removed they can become difficult to remove, causing avoidable complications and often requiring lifelong warfarin. In this study, two sequential audits of retrieval of temporary IVC filters were conducted before and after the implementation of a coordinated management strategy for IVC filter follow-up. 33 filter placements were examined over a 15-month period (Group A). Following implementation of the strategy a comparable 15-month period in which 33 IVC filters were placed was audited (Group B). Following implementation, failed retrievals dropped from 15% to 9%. The number successfully retrieved did not change at 45%. The number made permanent from the outset following expert discussion increased from 12% to 39%. The number of filters with no attempted retrieval and no consultation about retrieval decreased from 27% to 9% (these patients were lost to follow-up with multiple contact attempts made). In Group B 100% of placed IVC filters were followed up appropriately. The proposed model is an easily implemented plan to avoid patient morbidity caused by temporary IVC filters made unintentionally permanent by loss to follow-up.
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Caitriona
C
Logan
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Niamh
N
O'Connell
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
John
J
Kavanagh
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Niall
N
McEniff
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Mark
M
Ryan
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Michael
M
Guiney
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Orla
O
Seery
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
James
J
O'Donnell
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Kevin
K
Ryan
National Center for Hereditary Coagulation Disorders, St. James's Hospital, Dublin 8, Ireland.
Barry
B
White