COST-EFFECTIVE METHOD FOR BEDSIDE INSERTION OF VENA-CAVAL FILTERS IN TRAUMA PATIENTS

Background: The need for patient transport for inferior vena cava (IVC ) filter placement impacts patient safety, comfort, charges, and nursi ng care. Bedside, ultrasound-guided IVC filter placement may offer an acceptable, cost-effective alternative. Methods: Prospective cohort st udy 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 rec orded, and the potential financial savings were determined. Results: O f 3,172 trauma admissions, 55 patients met IVC filter criteria and 49 patients had IVC filters placed under ultrasound guidance. In six pati ents (10.9%), ultrasound guided filter placement failed. There were fo ur 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: Ultrasoun d guided, bedside placement of IVC filters is a safe, cost-effective m ethod of pulmonary embolism prophylaxis in select trauma patients.