Catheter-directed treatment for acute pulmonary embolism increased over time, with a 1.3% reduction in in-hospital mortality compared to a nationwide sample.
Does management by a Pulmonary Embolism Response Team (PERT) improve in-hospital mortality and length of stay in patients with acute pulmonary embolism compared to a matched nationwide sample?
Management of acute pulmonary embolism within a PERT framework is associated with increased use of catheter-directed therapies, lower in-hospital mortality, and shorter hospital stays compared to a matched national sample.
Absolute Event Rate: 0% vs 0%
Abstract Aims Multidisciplinary pulmonary embolism response teams (PERTs) are being established in hospitals worldwide to address the increasing complexity in acute PE management. To identify recent trends in PERT decisions regarding advanced treatment of acute severe PE. Methods and results We analysed data from the prospective multicentre PERT™ Consortium registry (years 2018–2024), focusing on catheter-directed treatment (CDT) and including systemic thrombolysis, surgical embolectomy, and extracorporeal membrane oxygenation (ECMO). An age-, sex-, and PE risk-matched population from the US Nationwide Inpatient Sample (NIS) was used for comparison. Among 11 436 patients enrolled at 51 sites (median age, 65 years; 13.7% high-risk and 62.5% intermediate-risk PE), 2639 (23.1%) underwent CDT. Of those, 140 (5.3%) underwent catheter-directed thrombolysis without ultrasound, 851 (32.2%) ultrasound-assisted catheter thrombolysis, and 1534 (58.1%) mechanical thrombectomy/aspiration. Systemic thrombolysis was used in 5.6%, surgical embolectomy in 1.1%, and ECMO in 1.6% of all patients. Trends of CDT increased over time (+0.36% quarterly by linear regression; P = 0.002), with increase in mechanical thrombectomy (+0.83%; P 0.001) and decrease in catheter-directed thrombolysis (−0.4%; P = 0.001). Matching 10 883 patients from the PERT™ Consortium registry to the NIS population, we found a 22% (95% CI, 21–23%) standardized mean difference in CDT use, 1.3% (0.6–2.0%) lower in-hospital mortality, and 0.75 (0.2–1.3) fewer days of hospital stay among PERT™ Consortium registry patients. Conclusion In a national quality assurance database of patients with PE included in the PERT registry, the use of catheter-directed treatment increased over time. Compared with a nationwide NIS sample, these patients had lower in-hospital mortality and shorter hospital length of stay.
Farmakis et al. (Fri,) reported a other. Catheter-directed treatment for acute pulmonary embolism increased over time, with a 1.3% reduction in in-hospital mortality compared to a nationwide sample.
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