Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.20210186
Jornal Vascular Brasileiro
Original Article

Temporal trends in vena cava filter implantation in public health system inpatients: an 11-year analysis of the largest city in Brazil

Tendência temporal do implante de filtro de veia cava em pacientes internados no SUS em São Paulo: análise de 11 anos da maior cidade do Brasil

Dafne Braga Diamante Leiderman; Marcelo Fiorelli; Marcelo Passos Teivelis; Nickolas Stabellini; Edson Amaro Júnior; Nelson Wolosker

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Abstract

Abstract: Background: Vena cava filter implantation is considered a simple procedure, which can lead to overuse and over-indication. It is nevertheless associated with short and long-term complications.

Objectives: The goals of this study were to evaluate rates of vena cava filter implantation conducted by Brazil’s Unified Public Health System, analyzing in-hospital mortality and migration of patients from other cities seeking medical attention in São Paulo.

Methods: This study analyzed all vena cava filter procedures conducted from 2008 to 2018 in the city of São Paulo and registered on the public database using a big data system to conduct web scraping of publicly available databases.

Results: A total of 1324 vena cava filter implantations were analyzed. 60.5% of the patients were female; 61.7% were under 65 years old; 34.07% had registered addresses in other cities or states; and there was a 7.4% in-hospital mortality rate.

Conclusions: We observed an increase in the rates of use of vena cava filters up to 2010 and a decrease in rates from that year onwards, which coincides with the year that the Food and Drug Administration published a recommendation to better evaluate vena cava filter indications.

Keywords

inferior vena cava filter, epidemiology, public health system, mortality rate, thrombosis, pulmonary embolism

Resumo

Resumo: Contexto: O implante de filtro de veia cava é considerado um procedimento de baixa complexidade, o que pode resultar em indicação excessiva. No entanto, não é isento de complicações a curto e longo prazo.

Objetivos: Avaliar as taxas de implantes de filtro de veia cava realizados pelo Sistema Único de Saúde e a origem geográfica e mortalidade intra-hospitalar dos pacientes.

Métodos: Foi conduzida uma análise em um banco de dados públicos referente às taxas de implantes de filtro de veia cava realizados de 2008 a 2018 na cidade de São Paulo, utilizando o sistema de big data.

Resultados: Foram analisados 1.324 implantes de filtro de veia cava financiados pelo Sistema Único de Saúde. Identificou-se tendência de aumento da taxa de implantação até 2010 e de redução dos números após esse período. Do total de pacientes, 60,5% eram do sexo feminino; 61,75% tinham menos de 65 anos; e 34,07% possuíam endereço oficial em outra cidade ou estado. A taxa de mortalidade intra-hospitalar foi de 7,4%.

Conclusões: Observamos aumento das taxas de implante de filtro de veia cava até 2010 e redução das taxas após esse período, o que coincide com o ano em que a organização norte-americana Food and Drug Administration publicou uma recomendação para melhor avaliar as indicações de filtros.
 

Palavras-chave

filtro de veia cava, epidemiologia, sistema público de saúde, taxa de mortalidade, trombose, embolia pulmonar

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Submitted date:
11/08/2021

Accepted date:
01/26/2022

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