Science and evidence-based research is, by its very design, difficult. There are hurdles that must be overcome at every step of the way as the researcher actively searches for ways that their study could be invalidated. But, in the end, the goal of every study remains the same: to ask a question and to be able to arrive at a definitive answer; or, at the very least, to take a step toward clarifying an answer.
In the case of a study recently published in the surgical journal of the Journal of the American Medical Association, that question was whether IVC filters affect mortality in trauma patients. Putting it another way – does the use of an IVC filter in a trauma patient play any role in keeping that patient from dying.
And the conclusion of the study was simple: no. There is no significant difference in the survival rates of trauma patients that have been implanted with IVC filters versus those that had not.
This study, combined with the knowledge of how many IVC filters stay implanted in patients’ bodies rather than being removed once the threat of blood clots has passed, amplifies concerns that one of the most widely used surgical implants available could possibly be doing more harm than good.
Data presented in the JAMA Surgery study showed that in the groups monitored by the researchers, ‘just eight percent of the filters were eventually removed over an average follow-up of 3.8 years.” That’s actually better than average. Current statistics indicate that, on average, less than one-third of all IVC filters are ever retrieved after they’ve been implanted.
Yet, leaving the devices in place does contribute to higher risks for a large number of complications, including death. Seemingly, the net effect then, is that a patient has been implanted with a device that, in these circumstances, shows no benefit to that patient. That device must now be retrieved.
Retrieval surgery carries risks. Leaving the device in place carries risks. And a patient’s life now hangs in the balance.
The study does leave the door open to other possible use cases for IVC filters after a trauma. “What has yet to be determined,” the authors write, “is if there are populations of patients with specific patterns of injury after trauma that may gain benefit from IVC filter insertion, and certainly further prospective investigations would be informative.”
However, under the circumstances presented by this study, one can’t help but wonder if the best treatment might be to leave the IVC filter out entirely.
