Impact of pulmonary embolism response team involvement on early outcomes in intermediate–high and high-risk pulmonary embolism: An observational single-center study

Objective: Pulmonary embolism response teams (PERTs) facilitate rapid multidisciplinary management of acute pulmonary embolism (PE), particularly in intermediate–high (IHR) and high-risk (HR) patients. However, benefits remain inconsistent, due to PERT structure differences across institutions worldwide. This study evaluated PERT effectiveness in an Asian healthcare setting, focusing on IHR and HR PE, thereby contributing to the global evidence on PERT. Methods: This prospective, single-center observational study included 129 consecutive patients with IHR and HR acute PE confirmed by computed tomography pulmonary angiography (CTPA). Patients were managed with or without PERT involvement. The primary outcome was a composite adverse outcome, defined as in-hospital mortality, 30-day post-discharge mortality, or 30-day readmission. Relative risks were estimated using log-binomial regression. Results: PERT activation tended to occur in patients with higher cardiac biomarker levels and more marked right ventricular dysfunction, patients with cancer were more frequently managed without PERT involvement. Advanced therapy use was higher in the PERT group (14.9% vs. 56.5%, p < 0.001). After adjustment for PESI score, ESC risk category, and discharge anticoagulation status, PERT involvement was independently associated with lower risk of the composite adverse outcome (adjusted RR 0.58, 95% CI 0.38–0.90, p = 0.029). Conclusions: In patients with IHR and HR acute PE, PERT involvement was independently associated with lower risk of a composite adverse outcome, including mortality and readmission. Selective PERT activation in patients with more severe clinical profiles may maximize benefit while minimizing workload.