Inferior vena cava filters (IVCF) are associated with complications which may be due
to delayed retrieval. Initiation of an automated reminder system may improve retrieval
rates and reduce complications. A computerized reminder system, which provides interactive
email reminders after implantation while collecting IVCF use data, was implemented.
IVCF retrieval was compared before (“reminder not provided” group) and after (“reminder
provided” group) implementation. Data regarding implantation, retrieval, and complications
were collected. The primary efficacy outcome was retrieval rate, and the primary safety
outcome was indwelling complication rate. Secondary outcomes were time to retrieval
and a composite adverse outcome defined as IVCF thrombosis, deep venous thrombosis
(DVT), pulmonary embolism, and death. A total of 1,070 IVCF insertions were included,
715 in the “reminder not provided” group and 355 in the “reminder provided” group.
Patient age (61 vs 64 years, p = 0.95) and gender (42% vs 40% female, p = 0.55) were
similar in the “reminder not provided” and “reminder provided” groups, respectively.
In the “reminder provided” group, the retrieval rate was higher (148/297 [49.8%] vs
223/715 [31.2%], p = 0.0001), the indwelling complication rate was lower (30/319 [9.4%]
vs 115/715 [16.1%], p = 0.005), and the time to retrieval was shorter (112 days vs
146 days, p = 0.02). The composite adverse outcome occurred less frequently in the
“reminder provided” group: (85/355 [23.9%] vs 297/715 [41.5%], p = 0.0001). The system
was associated with increased odds of IVCF retrieval (odds ratio 2.56; 95% confidence
interval: 1.82 to 3.59; p <0.0001) and reduced odds of the composite adverse outcome
(odds ratio 0.72; 95% confidence interval: 0.60 to 0.80; p <0.0001). In conclusion,
implementing a computerized email reminder system was associated with higher IVCF
retrieval rates, fewer indwelling complications, and shorter dwell times.
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Article Info
Publication History
Published online: October 18, 2018
Received in revised form:
September 19,
2018
Received:
July 12,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
