title: Indications, complications and outcomes of elderly patients undergoing retrievable inferior vena cava filter placement.
abstract: OBJECTIVE
  The utilization of inferior vena cava filter placement for pulmonary embolism prevention in elderly patients has not been well characterized. The present study aimed to review indications, complications and follow-up data of elderly patients undergoing inferior vena cava filter placement.
  
  
  METHODS
  A retrospective review was carried out of consecutive admitted patients who underwent inferior vena cava filter insertion at a large university hospital with a level I trauma center.
  
  
  RESULTS
  Overall, 455 retrievable filters were inserted between 2009 and 2014. A total of 133 patients (29.2%) were aged ≥70 years. Elderly patients were less likely to have their filter retrieved compared with non-elderly patients (5.3% vs 21.4%, P < 0.001). Filter-related complications occurred in 13% of non-elderly patients and 14.3% of elderly patients (P = 0.72), most of them occurring in the first 3 months after filter placement. Survival among elderly patients with no evidence of active malignancy was similar to the non-elderly patients with a 1-year survival rate of 76.3% versus 82% in non-elderly patients (P = 0.22), and a 2-year survival rate of 73.1% versus 78.6% in non-elderly patients (P = 0.27). Although decreased, survival rates among elderly patients with active cancer were still substantial, with a 1-year survival rate of 45% and 2-year survival rate of 40%.
  
  
  CONCLUSIONS
  Elderly patients had significantly lower rates of filter retrieval with similar complication rate. Survival rates among elderly patients were substantial, and in elderly patients with no active cancer were even comparable with non-elderly patients. When feasible, filter retrieval should be attempted in all elderly patients in order to prevent filter-related complications. Geriatr Gerontol Int 2017; 17: 1508-1514.
authors.affiliation: Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Amihai
authors.initials: A
authors.lastname: Rottenstreich
authors.affiliation: Braun School of Public Health and Community Medicine, Faculty of Medicine of the Hebrew University and Hadassah, Jerusalem, Israel.
authors.forename: Geffen
authors.initials: G
authors.lastname: Kleinstern
authors.affiliation: Department of Radiology, Interventional Radiology Section, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Allan I
authors.initials: AI
authors.lastname: Bloom
authors.affiliation: Department of Radiology, Interventional Radiology Section, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Klimov
authors.affiliation: Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Yosef
authors.initials: Y
authors.lastname: Kalish
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology*; D011655:Pulmonary Embolism / Q000517:prevention & control*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior
chemical_list: D000925:Anticoagulants
keywords: deep vein thrombosis; elderly; filter retrieval; inferior vena cava filter; pulmonary embolism