Impact of Vena Cava Filters on In-hospital Case Fatality Rate from Pulmonary Embolism

2012 ◽  
Vol 125 (5) ◽  
pp. 478-484 ◽  
Author(s):  
Paul D. Stein ◽  
Fadi Matta ◽  
Daniel C. Keyes ◽  
Gary L. Willyerd
Keyword(s):  
Pulmonary Embolism ◽  
Case Fatality Rate ◽  
Vena Cava ◽  
Case Fatality ◽  
Fatality Rate ◽  
Hospital Case ◽  
Vena Cava Filters

scholarly journals Vena Cava Filters and In-Hospital Case Fatality Among Patients With Pulmonary Embolism: Results From a Large Population-Based Study

2019 ◽  
Vol 25 ◽  
pp. 107602961988802 ◽  
Author(s):  
Fulvio Pomero ◽  
Walter Ageno ◽  
Francesco Dentali ◽  
Luigi Fenoglio ◽  
Alessandro Squizzato ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Case Fatality Rate ◽  
Large Population ◽  
Vena Cava ◽  
Case Fatality ◽  
First Episode ◽  
Fatality Rate ◽  
Hospital Case ◽  
Vena Cava Filters ◽  
Acute Pe

In patients with venous thromboembolism (VTE), vena cava filters (VCFs) are currently only recommended when anticoagulant treatment is contraindicated or if VTE has recurred despite adequate anticoagulation. However, evidence on the efficacy of filter in patients with VTE is not compelling. We evaluated potential efficacy of VCF in reducing in-hospital mortality in a large population of patients presenting with a first episode of pulmonary embolism (PE). Patients were collected using regional hospital-discharge databases covering a population of more than 13 million of inhabitants in Northern Italy. For each year of observation, we calculated the proportion of cases with VCF among all PE incident cases. The temporal trend of VCF application during the study period was also derived. The effect of VCF use on in-hospital case-fatality rate was evaluated with a multivariate regression model and with the use of propensity score matching. During the study period (2002-2012), 60 813 patients were hospitalized for a first episode of acute PE. In-hospital case-fatality rate for PE was 13.3%. Vena cava filters were used in 745 (1.22%) patients. The annual use of VCF remained stable from 2002 to 2008, while it progressively decreased afterward. After adjustment for available confounders, case-fatality rate remained significantly lower in patients who received VCF compared to the one registered in patients who did not (odds ratio [OR] 0.46; 95% confidence interval [CI]: 0.34-0.62). Propensity score matching gave similar results (OR: 0.42; 95% CI: 0.30-0.61). Vena cava filters were infrequently used in patients with acute PE. Insertion of VCF appeared to sensibly reduce all-cause in-hospital mortality in this subgroup of patients.

Vena cava filters in hospitalised patients with chronic obstructive pulmonary disease and pulmonary embolism

2013 ◽  
Vol 109 (05) ◽  
pp. 897-900 ◽  
Author(s):  
Fadi Matta ◽  
Paul D. Stein
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Embolism ◽  
Pulmonary Disease ◽  
Case Fatality Rate ◽  
Vena Cava ◽  
Case Fatality ◽  
Chronic Obstructive ◽  
Fatality Rate ◽  
Obstructive Pulmonary Disease ◽  
Vena Cava Filters

SummaryIn view of the high case fatality rates of patients with chronic obstructive pulmonary disease (COPD) who have pulmonary embolism (PE) we speculated that such patients might benefit from vena cava filters. To test this hypothesis we assessed the database of the Nationwide Inpatient Sample. From 1998–2009, 440,370 patients were hospitalised with PE and COPD who were not in shock or ventilator-dependent and did not receive thrombolytic therapy or pulmonary embolectomy. In-hospital all-cause case fatality rate among those with filters was 5,890 of 68,800 (8.6%) (95% confidence interval [CI] = 8.4–8.8) compared with 38,960 of 371,570 (10.5%) (95% CI = 10.4–10.6) (p<0.0001) who did not receive filters. Case fatality rate was age-dependent. Only those who were older than aged 50 years had a lower in-hospital all-cause case fatality rate with filters. Among such patients, absolute risk reduction was 2.1% (95% CI = 1.9–2.3). The greatest reduction of case fatality rate with vena cava filters was shown in patients >aged 80 years, 11,720 of 81,600 (14.4%) compared with 1,570 of 17,220 (9.1%) (p<0.0001). In conclusion, a somewhat lower in-hospital all-cause case fatality rate was shown with vena filters in stable patients with PE >aged 50 years who also had COPD. The benefit was greatest in elderly patients. The benefit in terms of a decreased case fatality rate would seem to outweigh the risks of vena cava filters in such patients.

Time trends and case fatality rate of in-hospital treated pulmonary embolism during 11 years of observation in Northwestern Italy

2016 ◽  
Vol 115 (02) ◽  
pp. 399-405 ◽  
Author(s):  
Walter Ageno ◽  
Fulvio Pomero ◽  
Luigi Fenoglio ◽  
Alessandro Squizzato ◽  
Matteo Bonzini ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Incidence Rate ◽  
Time Trends ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Fatality Rate ◽  
Entire Study ◽  
Mortality And Morbidity ◽  
Hospital Case

SummaryPulmonary embolism (PE) is a common disorder with high mortality and morbidity rates. However, population-based information on its incidence and prognosis remains limited. We conducted a large epidemiology study collecting data on hospitalisation for PE (from 2002 to 2012) in a population of about 13 million people in Northwestern Italy. Patients were identified using the ICD-9-CM codes: 415.11, 415.19; gender and age specific incidence rate of PE during the study period were estimated using the resident population for each year of the study. Furthermore, time trends in the in-hospital PE-related mortality and case fatality rate were calculated. Results were adjusted for possible confounders. A total of 60,853 patients (mean age 72.8 years, ± 14.1, 59.6 % females) with PE were included; the overall crude incidence rate for the entire study period was 55.4 and 40.6 events per year per 100,000 inhabitants for women and men, respectively (p < 0.001). However, this difference was completely lost after standardisation for age. The incidence of PE significantly increased in both genders during the study period. In-hospital case fatality rate significantly decreased throughout the study period (p < 0.001) in women (from 15.6 % to 10.2 %) and in men (from 17.6 % to 10.1 %). The observed decrease of the in-hospital case-fatality throughout the study period remained significant also after adjustment for possible confounders. In conclusion, time trends over an 11-year period show an increasing incidence of PE, but a significant reduction in mortality during hospitalisation. Reduction in the case fatality rate remained significant after adjustment for these possible confounders.Supplementary Material to this article is available online at www.thrombosis-online.com.

scholarly journals Declining Trend in the In-Hospital Case-Fatality Rate From Acute Myocardial Infarction in Miyagi Prefecture From 1980 to 1999

2001 ◽  
Vol 65 (11) ◽  
pp. 941-946 ◽  
Author(s):  
Jun Watanabe ◽  
Kaoru Iwabuchi ◽  
Yoshito Koseki ◽  
Mitsumasa Fukuchi ◽  
Tsuyoshi Shinozaki ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Hospital Case ◽  
Miyagi Prefecture

scholarly journals COVID-19: Spatial Analysis of Hospital Case-Fatality Rate in France

2020 ◽  
Author(s):  
Marc SOURIS ◽  
Jean-Paul Gonzalez
Keyword(s):  
International Organizations ◽  
Rate Ratio ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Healthcare Systems ◽  
Fatality Rate ◽  
Average Case ◽  
Hospital Case ◽  
Reporting Systems ◽  
Overall Efficiency

When the population risk factors and reporting systems are similar, the assessment of the case-fatality (or lethality) rate (ratio of cases to deaths) represents a perfect tool for analyzing, understanding and improving the overall efficiency of the health system. The objective of this article is to estimate the influence of the hospital care system on lethality in metropolitan France during the inception of the COVID-19 epidemic, by analyzing the spatial variability of the hospital case-fatality rate between French districts (i.e. French departements). The results show that the higher case-fatality rates observed by districts are mostly related to the level of morbidity, therefore to the overwhelming of the healthcare systems during the acute phases of the epidemic. However, the magnitude of this increase of case-fatality rate represents less than 10 per cent of the average case-fatality rate and cannot explain the magnitude of the variations in case-fatality rate reported per country by international organizations or information sites. These differences can only be explained by the systems for reporting cases and deaths, which, indeed, vary greatly from country to country, and not attributed to the care or treatment of patients, even during hospital stress due to epidemic peaks.

Association of digoxin therapy with case fatality rate in acute pulmonary embolism

2020 ◽  
Author(s):  
Mehmet Baran Karataş ◽  
Nizamettin Selçuk Yelgeç ◽  
Yiğit Çanga ◽  
Ahmet Zengin ◽  
Ayşe Emre
Keyword(s):  
Pulmonary Embolism ◽  
Case Fatality Rate ◽  
Acute Pulmonary Embolism ◽  
Case Fatality ◽  
Fatality Rate ◽  
Digoxin Therapy
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