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Cost-Effective Method for Bedside Insertion of Vena Caval Filters in Trauma Patients

Nunn, Craig R. MD; Neuzil, Daniel MD; Naslund, Thomas MD; Bass, John G. BA; Jenkins, Judith M. MSN; Pierce, Rosanna RN; Morris, John A. Jr, MD, FACS

The Journal of Trauma: Injury, Infection, and Critical Care: November 1997 - Volume 43 - Issue 5 - p 752-758

Background  The need for patient transport for inferior vena cava (IVC) filter placement impacts patient safety, comfort, charges, and nursing care. Bedside, ultrasound-guided IVC filter placement may offer an acceptable, cost-effective alternative.

Methods  Prospective cohort study of 55 consecutive trauma patients requiring IVC filter placement. During a 13-month period (August of 1995-September of 1996), patients meeting criteria for IVC filter were evaluated. Complications were recorded, and the potential financial savings were determined.

Results  Of 3,172 trauma admissions, 55 patients met IVC filter criteria and 49 patients had IVC filters placed under ultrasound guidance. In six patients (10.9%), ultrasound guided filter placement failed. There were four complications in four patients (8.2%). Over 13 months, charges were reduced by $69,800 when compared with radiology suite placement and $118,300 when compared with operative placement.

Conclusions  Ultrasound guided, bedside placement of IVC filters is a safe, cost-effective method of pulmonary embolism prophylaxis in select trauma patients.

From the Department of Surgery, the Division of Trauma/Surgical Critical Care (C.R.N., J.A.B., J.M.J., J.A.M.,), and the Division of Vascular Surgery (D.N., T.N., R.P.), Vanderbilt University Medical Center, Nashville, Tennessee.

Presented at the 27th Annual Meeting of the Western Trauma Association, March 1-8, 1997, Snowbird, Utah.

Address for reprints: Craig R. Nunn, MD, Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, 243 Medical Center South, 2100 Pierce Avenue, Nashville, TN 37212.

© Williams & Wilkins 1997. All Rights Reserved.