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Comment & Response
July 2017

Inferior Vena Caval Filter Insertion in Trauma Patients

Author Affiliations
  • 1National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia
JAMA Surg. 2017;152(7):706. doi:10.1001/jamasurg.2017.0468

To the Editor We wish to comment on the methods and analyses related to the publication by Sarosiek et al1 on inferior vena caval filter (IVCF) insertion in trauma patients and the associated Invited Commentary.2 The article is a trauma subset analysis of a previous article3 on overall IVCF at a single institution. In the most recent article by Sarosiek et al,1 patients with IVCF were not matched against indications for IVCF insertion in trauma. Instead, the authors used age, sex, race/ethnicity, and Injury Severity Score (ISS) to develop a propensity score to find matched data sets. The matching is based on covariates that are not potential confounders rather than covariates that are potential confounders. Importantly, none of the variables used are indications for IVCF insertion. The authors did not have the data detail in their registry or the resources to extract the data required for appropriate matching. They have somewhat mentioned this in the limitations. The authors’ position seems to be that IVCF insertion is a random event.