A nomogram model to predict non-retrieval of short-term retrievable inferior vena cava filters

Objective: To develop and validate a nomogram for predicting non-retrieval of the short-term retrievable inferior vena cava (IVC) filters.

Methods: In this study, univariate and multivariate logistic regression analyses were performed to identify predictive factors of short-term retrievable filter (Aegisy or OptEase) non-retrieval, and a nomogram was then established based on these factors. The nomogram was created based on data from a training cohort and validated based on data from a validation cohort. The predictive value of the nomogram was estimated using area under the curve (AUC) and calibration curve analysis (Hosmer-Lemeshow test).

Results: A total of 1,321 patients who had undergone placement of short-term retrievable filters (Aegisy or OptEase) were included in the analysis. The overall retrieval rate was 68.7%. Age, proximal and distal deep vein thrombosis (DVT) vs. distal DVT, active cancer, history of long-term immobilization, VTE was detected in the intensive care unit, active/recurrent bleeding, IVC thrombosis, and history of venous thromboembolism were independent predictive risk factors for non-retrieval of filters. Interventional therapy for DVT, acute fracture, and interval of ≥14 days between filter placement and patient discharge were independent protective factors for non-retrieval of filters. The nomogram based on these factors demonstrated good ability to predict the non-retrieval of filters (training cohort AUC = 0.870; validation cohort AUC = 0.813.

Conclusion: This nomogram demonstrated strong predictive accuracy and discrimination capability. This model may help clinicians identify patients who are not candidates for short-term retrievable filter placement and help clinicians make timely, individualized decisions in filter choice strategies.