Trauma patients may have an increased risk of thromboembolic disease. Placement of a filter in the inferior vena cava may be indicated as a prophylactic measure if certain conditions are present. The following guidelines were developed by the Eastern Association for the Surgery of Trauma (EAST).


Requirement: The patient is without deep vein thrombosis or pulmonary embolus.


Criteria for prophylactic placement - All of the following:

(1) The patient cannot receive anticoagulation.

(2) The patient is > 45 years of age and/or has poor cardiopulmonary reserve.

(3) One of more of the following injury patterns:

(3a) closed head injury with Glasgow Coma Score < 8

(3b) spinal cord injury with paraplegia or quadriplegia

(3c) complex pelvic fractures with associated long-bone fractures

(3d) multiple long-bone fractures


Patients who may benefit most from filter placement:

(1) age >= 60

(2) spinal cord injury

(3) poor cardiopulmonary reserve

(4) very high risk of venous thromboembolism


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