A Multidisciplinary Quality Improvement Project Leads to Improved Patient Follow-up and Filter Retrieval Rate

Lihao Qin; Feng Tian; Kai Wang; Youjun Mao; Linghong Hu; Tongqing Xue; Zhongzhi Jia; Tao Tao

doi:10.1016/j.avsg.2024.12.056

A Multidisciplinary Quality Improvement Project Leads to Improved Patient Follow-up and Filter Retrieval Rate

Ann Vasc Surg. 2024 Dec 26:S0890-5096(24)00876-8. doi: 10.1016/j.avsg.2024.12.056. Online ahead of print.

Authors

Lihao Qin¹, Feng Tian¹, Kai Wang¹, Youjun Mao², Linghong Hu¹, Tongqing Xue³, Zhongzhi Jia⁴, Tao Tao⁵

Affiliations

¹ Department of Interventional and Vascular Surgery, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China, 213003.
² Department of Vascular Surgery, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China, 213003.
³ Department of Interventional Radiology, Huaian Hospital of Huai'an City (Huaian Cancer Hospital), Huai'an, China, 223200. Electronic address: vh6376@163.com.
⁴ Department of Interventional and Vascular Surgery, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China, 213003. Electronic address: jiazhongzhi.1998@163.com.
⁵ Department of Orthopedics, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China, 213003. Electronic address: iamgkdc@163.com.

PMID: 39732325
DOI: 10.1016/j.avsg.2024.12.056

Abstract

Objective: To identify risk factors for loss to follow-up after inferior vena cava (IVC) filter placement in inpatients of other departments (IODs) and to determine whether a quality improvement project launched at our institution in April 2022 improved follow-up and filter retrieval rates in these patients.

Methods: Consecutive patients who underwent retrievable filter placement at our institution between March 2021 and March 2023 were included in this study. Patients were divided into preimprovement (before April 2022; n = 81) and postimprovement (after April 2022; n = 77) groups. Risk factors for loss to follow-up were assessed in the preimprovement group, and filter retrieval rates were compared between groups.

Results: Acute cerebral hemorrhage (OR = 5.745; 95% CI: 1.471-22.434) and lack of requirement for follow-up by the referring department (OR = 3.435; 95% CI: 1.035-11.398) were identified as independent risk factors for loss to follow-up. The filter retrieval rate was higher in the postimprovement group (94.8%) than in the preimprovement group (69.1%; P <.001). The rate of loss to follow-up was lower in the postimprovement group (5.2%) than in the preimprovement group (30.9%; P <.001). The preimprovement group had a higher incidence of IVC perforation (9.6%) than the postimprovement group (0; P = .019) at the time of filter retrieval.

Conclusions: Acute cerebral hemorrhage and lack of requirement for follow-up by the referring department are independent risk factors for loss to follow-up among IODs. The quality improvement project at our institution improved follow-up and IVC filter retrieval rates in IODs.

Keywords: filter; inferior vena cava; retrieval.