Impact of an Integrated Electronic Health Record Protocol on Inferior Vena Cava Filter Retrieval Attempt Rates: An Observational Cohort Study.

Abstract

Introduction: To improve inferior vena cava (IVC) filter retrieval rates, an electronic health record prompt for scheduling retrieval before patient discharge was implemented.

Methods: This retrospective comparative cohort study was conducted in a single Midwestern tertiary care medical center. Adult patients with IVC filters placed for a medical (Medical subgroup) or trauma (Trauma subgroup) indication before and after protocol implementation and who had follow-up documented in the electronic health record were included. IVC filter retrieval attempt rates both overall and by indication for placement before and after protocol implementation were compared.

Results: Three hundred eighty-five patients met eligibility criteria: 223 before implementation (Before group) and 162 after implementation (After group). The attempted retrieval rate for the After group was 11.4% higher than the Before group (P = .012). Attempted retrieval rates in the Medical Before and After subgroups were 56.2% and 76.0%, respectively (P = .001). The Trauma subgroups' rates were similar to each other (P = .594). Time to retrieval attempt was significantly shorter in the Medical After subgroup than in the Medical Before subgroup (P = .018) but similar in the Trauma subgroups.

Conclusions: Attempted retrieval rates were significantly higher in the After group and Medical After subgroup. Trauma subgroup rates were similar, likely because a previous intervention to increase retrieval in trauma patients was in place during the pre-implementation period of our study. Findings suggest that using an automated electronic health record-based prompt to facilitate IVC filter retrieval scheduling could greatly improve retrieval rates and patient safety.