Decreasing trend in prophylactic inferior vena cava filter usage: a retrospective analysis of Indications, patient profiles, and complications at a level 1 trauma center in the United States.

PURPOSE: To analyze trends in the use of prophylactic inferior vena cava (pIVC) filters at a level 1 Trauma Center in the United States and evaluate indications, patient characteristics, and complications.

METHODS

A retrospective cohort study was conducted on adult trauma patients who received pIVC filters between January 2011 and October 2023. Demographic and clinical variables were collected. Indications, complication rates, and venous thromboembolism (VTE) outcomes were assessed. Temporal trends were analyzed using the Mann-Kendall trend test. Logistic regression analysis was used to identify predictors of VTE.

RESULTS

Among 300 patients in the cohort, there was a significant decline in pIVC filter use (Tau − 0.846, p < 0.001). Symptomatic VTE occurred in 23% of patients, and 13 (4%) experienced filter-related complications. Filters remained in place > 90 days in 81% of patients. Increased age (OR 1.17 per 10-year increase, p = 0.038), BMI (OR 1.26 per 5-point increase, p = 0.019), and male sex (OR 2.31, p = 0.026) were independently associated with VTE.

CONCLUSION

Prophylactic IVC filter use in trauma patients has declined significantly in recent years, consistent with guideline-driven recommendations. Despite more selective use, VTE and complication rates remain substantial, emphasizing the importance of careful patient selection and structured retrieval follow-up systems.