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• W2894574749 abstract "SESSION TITLE: Pulmonary Vascular Disease 1 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: Although the placement of inferior vena cava filters (IVCF) has been associated with vascular and mechanical complications, there has been limited investigation into the potential infectious complications of this intervention. We hypothesized that in patients admitted to our institution with deep vein thrombosis (DVT) or pulmonary embolism (PE) the incidence of clinically significant bacteremia would be higher in those patients who received an IVCF than those who did not receive an IVCF. METHODS: We performed a retrospective cohort study using clinical looking glass (CLG) (Clinical Analytics®, NY, NY) of adult patients admitted to Montefiore Medical Center between January 1st, 2006 and December 31st, 2009 who received a new diagnosis of DVT or PE by ICD-9 coding. IVCF placement was identified by the presence of a procedure insertion note. Bacteremia was identified from blood culture data using CLG. Patient characteristics were compared with chi-square testing for categorical variables or a t-test or Wilcoxon rank-sum test for continuous variables. Competing risks multivariable regression modeling was used to evaluate the association of IVCF placement with clinically significant bacteremia during the year following IVCF placement (or DVT/PE diagnosis in those who did not get an IVCF) while accounting for competing risk of death. Additional model covariates included sex, race, socioeconomic status, age adjusted Charlson co-morbidity index and known risk factors for bacteremia not already included in the Charlson score such as albumin < 3, end stage renal disease and administration of glucocorticoids within 6 months of cohort inclusion. RESULTS: During the specified time period 7100 patients met inclusion criteria, of whom 699 (9.9%) had an IVCF placed. Patients who received an IVCF were older (mean (SD) 69.3(14.7) vs. 63.1(17.7); P < 0.001) and had higher Charlson comorbidity score (median (IQR), 4(5) vs. 0(2); P < 0.001). IVCF patients were also more likely to have received glucocorticoids in the last 6 months (26.5% vs. 8.2%; P < 0.001) and have albumin < 3 (48.1% vs 7.1%; P < 0.001). Mortality after 1 year was higher in the group who received an IVCF (45.4% vs. 20.9%; P < 0.001). After multivariable adjustment and accounting for the competing risk of death, there was no associated increased risk of bacteremia with the placement of an IVCF (adjusted hazard ratio, 0.89 [95% CI, 0.65-1.20]; P = 0.44). CONCLUSIONS: In patients admitted for DVT or PE, we found no association between IVCF placement and clinically significant bacteremia up to one year after the IVCF was placed. CLINICAL IMPLICATIONS: Although the placement of IVCF in a patient with DVT or PE may be associated with future vascular or mechanical complications, we were unable to demonstrate an increased rate of infection in patients who received this intervention. DISCLOSURES: No relevant relationships by Abigail Chua, source=Web Response No relevant relationships by Daniel Fein, source=Web Response No relevant relationships by hayley gershengorn, source=Web Response No relevant relationships by shahistha hameed, source=Web Response" @default.
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• W2894574749 date "2018-10-01" @default.
• W2894574749 modified "2023-09-25" @default.
• W2894574749 title "THE IMPACT OF INFERIOR VENA CAVA FILTER PLACEMENT ON THE DEVELOPMENT OF BACTEREMIA" @default.
• W2894574749 doi "https://doi.org/10.1016/j.chest.2018.08.934" @default.
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