IVC filter placement in trauma patients is declining but shows wide variation among hospitals, affecting patient outcomes.

• Among 2.3 million trauma patients, only 0.81% had IVC filters placed, down from 1.15% in 2017 to 0.59% in 2024 (p<0.001).
• 22.5% of centers had insertion rates ≥1%, highlighting significant interhospital differences.

Higher IVC filter use did not improve in-hospital mortality but increased DVT, PE, and VTE rates (all p<0.001).

• An opportunity exists to refine guidelines and ensure appropriate filter use across trauma centers.