AI Article Synopsis
- The study examined the effects of pulmonary embolism response teams (PERTs) on patient outcomes by comparing data from three years before and after their implementation at a specific hospital.
- It found that despite an increase in risk assessment methods post-PERT, there was no significant difference in pulmonary embolism-related mortality rates (2.6% pre-PERT vs 2.9% post-PERT).
- Also, while the overall use of advanced therapies remained the same, the utilization patterns changed, with a decrease in systemic thrombolysis and an increase in catheter-directed therapy after PERT implementation.
Article Abstract
Background: Optimal management of acute pulmonary embolism requires expertise offered by multiple subspecialties. As such, pulmonary embolism response teams (PERTs) have increased in prevalence, but the institutional consequences of a PERT are unclear.
Methods: We compared all patients that presented to our institution with an acute pulmonary embolism in the 3 years prior to and 3 years after the formation of our PERT. The primary outcome was in-hospital pulmonary embolism-related mortality before and after the formation of the PERT. Sub-analyses were performed among patients with elevated-risk pulmonary embolism.
Results: Between August 2012 and August 2018, 2042 patients were hospitalized at our institution with acute pulmonary embolism, 884 (41.3%) pre-PERT implementation and 1158 (56.7%) post-PERT implementation, of which 165 (14.2%) were evaluated by the PERT. There was no difference in pulmonary embolism-related mortality between the two time periods (2.6% pre-PERT implementation vs 2.9% post-PERT implementation, P = .89). There was increased risk stratification assessment by measurement of cardiac biomarkers and echocardiograms post-PERT implementation. Overall utilization of advanced therapy was similar between groups (5.4% pre-PERT implementation vs 5.4% post-PERT implementation, P = 1.0), with decreased use of systemic thrombolysis (3.8% pre-PERT implementation vs 2.1% post-PERT implementation, P = 0.02) and increased catheter-directed therapy (1.3% pre-PERT implementation vs 3.3% post-PERT implementation, P = 0.05) post-PERT implementation. Inferior vena cava filter use decreased after PERT implementation (10.7% pre-PERT implementation vs 6.9% post-PERT implementation, P = 0.002). Findings were similar when analyzing elevated-risk patients.
Conclusion: Pulmonary embolism response teams may increase risk stratification assessment and alter application of advanced therapies, but a mortality benefit was not identified.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076889 | PMC |
| http://dx.doi.org/10.1016/j.amjmed.2020.03.058 | DOI Listing |
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