The role of prophylactic inferior vena cava filter in trauma patients at high risk for pulmonary embolism: system review and meta-analysis

Objective To evaluate the effectiveness and safety of the filter in trauma patients at high risk for pulmonary embolism (PE) without deep venous thrombosis (DVT). Methods Studies were searched in PubMed, Cochrane, Embase, SinoMed, CNKI, Wanfang Med Online, Vip Information and ClinicalTrials.gov, ranging from establishment of database to March 21, 2019. The main evaluation factors included: PE incidence rate, PE mortality rate, and DVT incidence rate. Meta-analysis was based on Review Manager 5.3. Results Six studies were included, including 811 cases with filter and 6 477 controls. Meta-analysis showed that implantation of prophylactic inferior vena cava filter was associated with a significant reduction in the incidence of PE (RR=0.32, 95%CI: 0.16-0.63, P=0.001) , and incidence of lethal PE (RR=0.20, 95%CI:0.04-0.96, P=0.05) . Yet prophylactic inferior vena cava filter was not associated with significant increase in DVT (RR=3.7, 95%CI: 0.23-60.54, P=0.36) . Conclusion Prophylactic inferior vena cava filter can reduce the incidence and mortality of PE in trauma patients at high risk for PE, without increasing the incidence of DVT. Key words: Vena cava filters; Venous thromboembolism; Venous thrombosis; Pulmonary embolism