Independent association between IVC filter placement and VTE risk in patients with upper gastrointestinal bleeding and isolated distal DVT: A retrospective cohort study

作者全名："Huang, Ying; Luo, Hailong; Liu, Xin; Li, Yanlin; Gong, Jing"

作者地址："[Huang, Ying; Luo, Hailong] Chongqing Med Univ, Affiliated Hosp 2, Dept Vasc Surg, Chongqing, Peoples R China; [Liu, Xin; Li, Yanlin; Gong, Jing] Chongqing Med Univ, Affiliated Hosp 2, Dept Emergency Med, 74 Linjiang Rd, Chongqing 400010, Peoples R China"

通信作者："Gong, J (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Emergency Med, 74 Linjiang Rd, Chongqing 400010, Peoples R China."

来源：VASCULAR MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001202015800001

JCR分区：Q2

影响因子：3

年份：2024

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期号：　

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结束页：　

文献类型：Article; Early Access

关键词：cohort study; gastrointestinal bleeding; inferior vena cava filters; venous thromboembolism (VTE)

摘要："Background: The placement of inferior vena cava (IVC) filters often emerges as an alternative preventative measure against pulmonary embolism in patients with upper gastrointestinal (GI) bleeding and isolated distal deep vein thrombosis (DVT). We aimed to investigate the association of IVC filter placement and the incidence of venous thromboembolism (VTE) recurrence in this patient population. Methods: We performed a retrospective cohort study including 450 patients with upper GI bleeding and isolated distal DVT. Propensity score matching using logistic regression was conducted to mitigate potential selection bias. Logistic regression models and additional sensitivity analyses were conducted to estimate the association between IVC filter implantation and VTE recurrence. Interaction and stratified analyses were also performed according to the background covariates. Results: Patients who underwent IVC filter placement were significantly younger than patients in the surveillance group (55.8 +/- 9.0 vs 58.4 +/- 11.2 years, p = 0.034). Patients in the IVC filter group demonstrated a higher distal thrombus burden. The VTE recurrence composite was significantly higher in patients who underwent IVC filter placement (44.1% [45/102] vs 25% [87/348], p < 0.001). Unmatched crude logistic regression analysis identified a significant association between IVC filter placement and VTE recurrence composite (OR = 2.37; 95% CI, 1.50-3.75). Sensitivity analyses yielded congruent outcomes. Conclusion: This study revealed an increased risk of VTE recurrence among patients receiving IVC filter placement, suggesting that IVC filter placement may not be suitable as a primary treatment for patients with upper GI bleeding and isolated distal DVT."

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