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Research Letter
Less Is More
December 10, 2018

Association of Inferior Vena Cava Filter Use With Mortality Rates in Older Adults With Acute Pulmonary Embolism

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, New York-Presbyterian Hospital, Columbia University Medical Center, New York
  • 2Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
  • 3Respiratory Department, Hospital Ramón y Cajal and Medicine Department, Universidad de Alcalá, Madrid, Spain
  • 4Associate Editor, JAMA Internal Medicine
  • 5Hospital Universitari Germans Trias i Pujol, Badalona, Spain
  • 6Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. Published online December 10, 2018. doi:10.1001/jamainternmed.2018.5287

Acute pulmonary embolism (PE) is a common cause of morbidity and mortality in older adults.1 Inferior vena cava (IVC) filters are frequently used to prevent subsequent PE; nearly 1 in 6 of elderly Medicare fee-for-service (FFS) beneficiaries with PE received an IVC filter.2 However, the evidence supporting device efficacy and safety is scant.3 In recent years, the US Food and Drug Administration raised concerns about the safety of IVC filters, and some studies have indicated a temporal decrease in the use of this technology.4 Meanwhile, some investigators, using administrative data with limited adjustments, have found that the use of IVC filters was associated with reduced mortality rates, recommending their use.5 This study sought to determine the association between use of IVC filters and mortality rates in Medicare FFS beneficiaries with PE using 3 distinct statistical approaches.

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