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January 11, 2019Pulmonary Circulation85 citationsOpen Access

A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

JSJacob Gammelgaard SchultzNGN. GiordanoHZHui Zheng

Key Points

  • This analysis aims to characterize patient management and outcomes in the first multicenter assessment of Pulmonary Embolism Response Teams in the US.
  • Enrolled patients from the National PERT Consortium™ registry with PERT activation from October 2016 to October 2017.

Structured PICO

What are the characteristics, treatments, and outcomes of patients managed by Pulmonary Embolism Response Teams in the US?

P
Population
475 unique PERT activations (416 with confirmed acute PE) from the National PERT Consortium multicenter registry in the United States.
I
Intervention
Care by a Pulmonary Embolism Response Team (PERT)
O
Outcome
Frequency of team activation, patient characteristics, PE severity, treatments delivered, and 30-day mortalityhard clinical

There is significant variability in team activation, PE severity, treatments delivered, and 30-day mortality among US Pulmonary Embolism Response Teams.

Abstract

Background We provide the first multicenter analysis of patients cared for by eight Pulmonary Embolism Response Teams (PERTs) in the United States (US); describing the frequency of team activation, patient characteristics, pulmonary embolism (PE) severity, treatments delivered, and outcomes. Methods We enrolled patients from the National PERT Consortium™ multicenter registry with a PERT activation between 18 October 2016 and 17 October 2017. Data are presented combined and by PERT institution. Differences between institutions were analyzed using chi‐squared test or Fisher's exact test for categorical variables, and ANOVA or Kruskal‐Wallis test for continuous variables, with a two‐sided P value < 0.05 considered statistically significant. Results There were 475 unique PERT activations across the Consortium, with acute PE confirmed in 416 (88%). The number of activations at each institution ranged from 3 to 13 activations/month/1000 beds with the majority originating from the emergency department (281/475; 59.3%). The largest percentage of patients were at intermediate–low (141/416, 34%) and intermediate–high (146/416, 35%) risk of early mortality, while fewer were at high‐risk (51/416, 12%) and low‐risk (78/416, 19%). The distribution of risk groups varied significantly between institutions ( P = 0.002). Anticoagulation alone was the most common therapy, delivered to 289/416 (70%) patients with confirmed PE. The proportion of patients receiving any advanced therapy varied between institutions ( P = 0.0003), ranging from 16% to 46%. The 30‐day mortality was 16% (53/338), ranging from 9% to 44%. Conclusions The frequency of team activation, PE severity, treatments delivered, and 30‐day mortality varies between US PERTs. Further research should investigate the sources of this variability.

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Cite This Study

Schultz et al. (2019) studied this question.

synapsesocial.com/papers/69fbd62d42e1b03a57368821https://doi.org/10.1177/2045894018824563
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