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Prophylactic IVC Filters Worsen Outcomes for Bariatric Surgery

WEDNESDAY, June 19, 2019 -- For patients undergoing bariatric surgery, use of prophylactic inferior vena cava filters (IVCFs) is associated with worse clinical outcomes and increased use of health care resources, according to a study published in the June 24 issue of JACC: Cardiovascular Interventions.

Satyajit Reddy, M.D., from the University of Illinois at Chicago, and colleagues identified obese patients who underwent bariatric surgery from January 2005 to September 2015. Outcomes associated with patients receiving prophylactic IVCFs prior to bariatric surgery were compared to those for patients who did not receive IVCFs using propensity score matching.

The researchers found that 0.41 percent of the 258,480 patients who underwent bariatric surgery had prophylactic IVCFs implanted. Compared with those without IVCFs, patients with prophylactic IVCFs had a significantly higher rate of the combined end point of in-hospital mortality or pulmonary embolism (1.4 versus 0.4 percent; odds ratio, 3.75). Prophylactic IVCFs also correlated with elevated rates of lower-extremity or caval deep vein thrombosis (1.8 versus 0.3 percent; odds ratio, 6.33), longer length of stay (median, three versus two days), and higher hospital charges (median, $63,000 versus $37,000).

"In the absence of randomized controlled trials or substantial prospective data, the routine use of prophylactic IVCFs in patients undergoing bariatric surgery is not indicated," the authors write.

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Posted: June 2019

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