Back to Search
Start Over
Impact of a pulmonary embolism response team initiative on hospital mortality of patients with bilateral pulmonary embolism.
- Source :
-
Medicina clinica [Med Clin (Barc)] 2023 Jun 09; Vol. 160 (11), pp. 469-475. Date of Electronic Publication: 2023 Feb 16. - Publication Year :
- 2023
-
Abstract
- Introduction: Pulmonary embolism (PE) response teams (PERT) for the management of high-risk PE (HR-PE) and intermediate-high risk PE (IHR-PE) are encouraged in PE guidelines. We aimed to assess the impact of a PERT initiative on mortality in these groups of patients, compared with standard care.<br />Methods: We conducted a prospective, single-center registry, including consecutive patients with HR-PE and IHR-PE with PERT activation from February-2018 to December-2020 (PERT group, n=78 patients) and compared it with an historic cohort of patients admitted to our hospital in a previous 2-year period (2014-2016), managed with standard of care (SC-group, n=108 patients).<br />Results: Patients in the PERT group were younger and less comorbid. The risk profile at admission and the percentage of HR-PE was similar in both cohorts (13% in SC-group and 14% in PERT-group, p=0.82). Reperfusion therapy was more frequently indicated in PERT-group (24.4% vs 10.2%, p=0.01), with no differences in fibrinolysis treatment, while catheter-directed therapy (CDT) was more frequent in PERT group (16.7% vs 1.9%, p<0.001). Reperfusion and CDT were associated with lower in-hospital mortality (2.9% vs 15.1%, p=0.001 for reperfusion and 1.5% vs 16.5%, p=0.001 for CDT). The primary outcome, 12-month mortality, was lower in the PERT-group (9% vs 22.2%, p=0.02), There were no differences in 30-day readmissions. In multivariate analysis PERT activation was associated with lower mortality at 12 months (HR 0.25, 95% confidence interval 0.09-0.7, p=0.008).<br />Conclusion: A PERT initiative in patients with HR-PE and IHR-PE was associated with a significant reduction in 12-month mortality compared with standard of care, and also with an increase in the use of reperfusion, especially catheter-directed therapies.<br /> (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 1578-8989
- Volume :
- 160
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Medicina clinica
- Publication Type :
- Academic Journal
- Accession number :
- 36801109
- Full Text :
- https://doi.org/10.1016/j.medcli.2022.12.017