Income, comorbidity predict inferior vena cava filter placement, retrieval in cancer patients

Income and several clinical factors are associated with placement and retrieval of inferior vena cava filter for patients with cancer-related thrombosis, a study has found. In addition, filter retrieval rates remain low despite reinitiation of anticoagulation in many patients.

The authors reviewed an insurance claims database to identify adults receiving cancer-directed therapy and had a new diagnosis of venous thromboembolism. Then, they assessed clinical and sociodemographic factors in patients with and without filter placement and retrieval.

Of the 25,788 patients (mean age 68.3 years) who met the eligibility criteria, 2,111 (8.2 percent) underwent filter placement. Income, comorbidities, malignancy, recent surgery, and the type of thrombosis correlated with filter placement.

Some 137 patients (6.5 percent) initiated anticoagulation therapy within 3 days of filter placement, while 612 (29 percent) received anticoagulation within 30 days following filter placement. However, only 159 patients (7.5 percent) had their filters retrieved during the study period despite treatment.

Of note, patients with income of $75,000–99,000 (odds ratio [OR], 2.13; p=0.012) or above $100,000 (OR, 1.8; p=0.038) were more likely to have their filter retrieved compared to those earning <$50,000. Younger patients and those with fewer comorbidities or without central nervous system or lung malignancies also had a higher likelihood of filter retrieval.

“Efforts are needed to address disparities in filter use and improve retrieval rates,” the authors said.

“Venous thromboembolism is a leading cause of death in patients with cancer. Inferior vena cava filters are utilized to mitigate the risk of pulmonary embolism for patients who have contraindication to, or failure of, anticoagulation,” they explained.