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Home > Vascular Annual Meeting > PVSS14. Trends in Utilization of Vena Caval Interruption

PVSS14. Trends in Utilization of Vena Caval Interruption

Phillip S. Moore, MD; Jeanette S. Andrews, MS; Timothy E. Craven, MSPH; Ross P. Davis, MD; Matthew A. Corriere, MD; Christopher C. Godshall, MD; Matthew E. Edwards, MD; Leslie H. Williams, MS; Randolph Geary, MD; Kimberley J. Hansen, MD
Wake Forest University Baptist Medical Center, Winston-Salem, NC

OBJECTIVES: To examine national trends in utilization of vena caval interruption (VCI) from 1998-2005.

METHODS: Hospital discharge data from the Nationwide Inpatient Sample (NIS) were used to examine trends in the utilization of VCI for the years 1998-2005 using methods for complex surveys. VCI performed in the absence of deep venous thrombosis (DVT) or pulmonary embolus (PE) was categorized as prophylactic (pVCI).
 
RESULTS: During the study period, the estimated rate of hospitalizations with a diagnosis of DVT or PE rose by 14% and 59%, respectively. The estimated weighted frequency of VCI increased from 52,860 procedures in 1998 to 104,114 procedures in 2005 (0.15% and 0.27% of all discharges, respectively), representing an 80% increase. Logistic regression models revealed that the rate of pVCI increased at a significantly higher rate than VCI associated with DVT/PE (176% vs. 42%; p=<0.001), after adjusting for age, gender, and hospital characteristics. Common diagnoses were selected to characterize the pVCI group: major surgery (59%), hemorrhage (29%), head injury/stroke (22%), extremity/pelvic fracture (22%), malignancy (19%), solid/hollow organ injury (19%), spine injury/paralysis (10%), and morbid obesity (6%). pVCI in the setting of morbid obesity and head injury/stroke rose significantly over time (p<0.001 and p=0.019, respectively), while pVCI associated with other diagnoses demonstrated no change. 10% of pVCI occurred in the absence of all the above diagnoses.

CONCLUSIONS: From 1998-2005, estimated rates of VCI increased almost two-fold while the rates of pVCI increased almost three-fold. Morbid obesity and head injury/stroke demonstrated significant increase in pVCI.

AUTHOR DISCLOSURES: P.S. Moore, None; J.S. Andrews, None; T.E. Craven, None; R.P. Davis, None; M.A. Corriere, None; C.C. Godshall, None; M.E. Edwards, None; L.H. Williams, None; R. Geary, None; K.J. Hansen, None.