Inferior Vena Cava Filters Prevent Pulmonary Emboli in Patients with Metastatic Pathologic Fractures of the Lower Extremity

Incidence and Risk Factors for Pulmonary Embolism After Primary Musculoskeletal Tumor Surgery

“…In the current series, the overall PE rate during hospitalization was 0.3% (10 of 3750), which is relatively low compared with the rates in previous reports [2,4,13,16,18,20,22,27]. One possible reason for this is the lower reported incidence of PE in Japanese patients compared with white patients [11].…”

“…The cited articles studied PE and VTE, unlike our study. The reported incidence of PE after musculoskeletal tumor surgery in earlier studies has varied widely, from 0.6% to 11% [2,13,16,27]. This wide range presumably results from heterogeneity among study subjects, small sample sizes, and variations in surveying for PE and in prophylaxis.…”

“…This wide range presumably results from heterogeneity among study subjects, small sample sizes, and variations in surveying for PE and in prophylaxis. In addition, most of these reports included large numbers of patients with cancer metastasis or hematologic malignancy, which are risk factors for PE [2,13,27]. Mitchell et al [16] reported that patients undergoing surgery for musculoskeletal sarcoma did not have a higher risk of PE than patients undergoing other routine orthopaedic procedures.…”

“…Mitchell et al [16] reported that patients undergoing surgery for musculoskeletal sarcoma did not have a higher risk of PE than patients undergoing other routine orthopaedic procedures. By contrast, some physicians believe that because of the perceived increased risk of PE in this population, inferior vena cava filters should be used in all patients with sarcoma undergoing surgery [2,27]. We used a large national database to try to estimate the frequency of this serious complication, and to determine what clinical parameters might be associated with an increased likelihood of a patient having a PE develop after musculoskeletal tumor surgery.…”

“…However, there is limited information available regarding the incidence, risk factors, and optimal prophylaxis for VTE in orthopaedic oncology patients, presumably because of the rarity of these diseases. The reported incidence of PE in these patients is between 0.6% and 11% [2,13,16,27], but these data were based on small and heterogeneous patient cohorts at a single referral center. The wide range of reported incidences may result from the inclusion of patients with metastatic bone tumors who may have a higher risk of PE.…”