INTRODUCTION Conflicting evidence exists regarding the role of inferior vena cava filters (IVCFs) in the prevention of pulmonary embolism. The aim of this study was to review an institutional policy of prophylactic IVCF placement in all operative pelvic and acetabular fractures as a means of preventing PE by comparing it to a historical prepolicy period of significantly less aggressive IVCF placement. METHODS The trauma registry of a single level 1 trauma center was retrospectively queried for all pelvic or acetabular fractures for the prepolicy and intervention periods as defined as January 2003-December 2008 and January 2009-December 2014, respectively-yielding 231 patients for analysis. The primary and secondary outcomes measured were the incidence of PE and deep vein thrombosis. RESULTS The rate of prophylactic IVCF insertion significantly increased during the study period (p < 0.001). The incidence of pulmonary embolism (1.8% vs. 5.1%, p = 0.351) and DVT (19.3% vs. 10.3%, p = 0.231) were not significantly different when comparing the prepolicy and intervention cohorts. In patients with operative fractures, a nonsignificant trend of increasing incidence of DVTs was appreciated in patients with a prophylactic IVCF versus those without prophylactic IVCF (13 vs. 2, p = 0.222). DISCUSSION A policy of increased use of prophylactic IVCFs in patients with operative pelvic and acetabular fractures failed to reduce the incidence of PE or DVT. In contrast, several case reports and institutional series have published several risks associated with IVCF placement including failure to retrieve temporary IVCF. CONCLUSION The benefit of prophylactic IVCF in this patient population is unclear.

中文翻译：

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预防性下腔静脉滤器用于盆腔手术性骨折：十二年的经验。

引言关于下腔静脉滤器（IVCF）在预防肺栓塞中的作用存在矛盾的证据。这项研究的目的是，通过将其与历史上积极性较低的IVCF放置的策略前时期进行比较，来回顾所有手术性盆腔和髋臼骨折中预防性IVCF放置的制度性政策，以预防PE。方法回顾性分析在2003年1月至2008年12月和2009年1月至2014年1月定义的政策和干预期间分别收治的231例患者的所有骨盆或髋臼骨折的单一1级创伤中心的创伤登记册。测量的主要和次要结局是PE的发生率和深静脉血栓形成。结果在研究期间，预防性IVCF插入率显着增加（p <0.001）。比较政策前和干预队列时，肺栓塞的发生率（1.8％vs. 5.1％，p = 0.351）和DVT（19.3％vs. 10.3％，p = 0.231）没有显着差异。在有手术性骨折的患者中，具有预防性IVCF的患者与无预防性IVCF的患者相比，DVT发生率增加的趋势不明显（13 vs. 2，p = 0.222）。讨论在术中骨盆和髋臼骨折患者中增加使用预防性IVCF的政策未能降低PE或DVT的发生率。相反，一些案例报告和机构系列文章已经发布了与IVCF放置相关的几种风险，包括无法检索临时IVCF。