Abstract
Background
Pulmonary Embolism Response Teams (PERT) were employed at multiple institutions to
bridge the gap between varied treatment options for acute PE and unclear evidence
for optimal management. There is limited data regarding the impact of PERT on the
use of advanced therapies and clinical outcomes.
Methods
We performed a retrospective single-center cohort study comparing patients that presented
to the ED with an acute PE before and after the creation of PERT in June 2017 at our
institution. We assessed utilization of advanced therapies, LOS, and mortality.
Results
A total of 817 patients (168 pre-PERT, 649 post-PERT) were evaluated in the ED with
an acute PE between October 2016 and December 2019. Both groups were similar in demographics,
comorbidities, and PESI score. There was a decrease in advanced therapy use (16 %
vs. 7.5 %, p = 0.006) after PERT creation. Most notable decreases were in catheter-based therapies
(8.5 % vs. 2.2 %, p = 0.008) and IVC filter placement (5.3 % vs. 3.2 %, p < 0.001). Median ICU LOS (2.5 days vs. 2.3 days, p = 0.55) and hospital LOS (3.1 vs. 3.0, p = 0.92) did not vary pre-PERT vs. post-PERT. In-hospital mortality (8.5 % vs. 5.0 %,
p = 0.29) and 30-day all-cause mortality (1.2 % vs. 0.5 %, p = 0.28) were not different between the two groups as well.
Conclusion
At our institution, PERT was associated with a decrease in advanced therapies administered
to acute PE patients without affecting mortality or LOS. Additional studies to assess
impact of this multi-disciplinary care team model on interventional therapies and
clinical outcomes for PE at a broader level are necessary.
Abbreviations:
CDT (catheter-directed thrombolysis or thrombectomy), CTPE (pulmonary embolism protocol CT), DVT (deep vein thrombosis), ECMO (extracorporeal membrane oxygenation), ED (Emergency Department), ESC (European Society of Cardiology), LOS (length of stay), PE (pulmonary embolism), PERT (Pulmonary Embolism Response Team), PESI (Pulmonary Embolism Severity Index)Keywords
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Article info
Publication history
Published online: November 24, 2022
Accepted:
November 21,
2022
Received in revised form:
November 7,
2022
Received:
September 3,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd.
