A28-14 Multidisciplinary Pulmonary Embolism Response Teams Reduce Mortality in Intermediate- And High-Risk Pulmonary Embolism: Systematic Review and Meta-Analysis

Rationale Intermediate- and high-risk pulmonary embolism (PE) carries substantial short-term mortality and often requires rapid decisions regarding thrombolysis, catheter-based intervention, or surgical embolectomy. Pulmonary Embolism Response Teams (PERTs) were created to deliver coordinated multidisciplinary evaluation and expedited reperfusion for severe PE. Whether PERT activation translates into measurable improvements in patient outcomes has remained uncertain. Methods A systematic review and study-level meta-analysis was performed of comparative studies reporting outcomes in adults with acute PE managed with a PERT model versus historical or concurrent non-PERT care. Studies were eligible if most patients met intermediate- or high-risk criteria (hemodynamic instability, RV dysfunction, or positive cardiac biomarkers) and if short-term all-cause mortality (in-hospital or 30-day) was reported. Secondary outcomes included use of advanced reperfusion therapy (systemic thrombolysis, catheter-directed thrombolysis/thrombectomy, or surgical embolectomy), major/clinically relevant bleeding, hospital length of stay (LOS), and ICU utilization. Random-effects models were used to pool odds ratios (OR) and mean differences. Results Twenty-four retrospective cohorts (n = 15,809 total patients; 6,228 managed with PERT and 9,581 without PERT) met inclusion criteria. Compared with standard care, PERT management was associated with significantly lower short-term all-cause mortality (pooled OR 0.72; 95% CI 0.56-0.93), despite a case mix enriched for higher-risk physiology. PERT involvement was also associated with markedly greater use of advanced reperfusion therapies (pooled OR 3.16; 95% CI 1.81-5.49), indicating more frequent escalation beyond anticoagulation alone. Importantly, this more aggressive strategy did not increase bleeding risk; major or clinically relevant bleeding events were lower with PERT (pooled OR 0.60; 95% CI 0.42-0.86). Hospital LOS was shorter in the PERT era by a pooled mean of 1.49 days (95% CI -2.59 to -0.39). Several studies also reported shorter ICU LOS once PERT was involved, consistent with faster stabilization and disposition. Conclusions For intermediate- and high-risk PE, activation of a multidisciplinary Pulmonary Embolism Response Team is associated with higher use of advanced reperfusion therapy, lower bleeding, shorter hospitalization, and a significant reduction in short-term mortality. These findings support PERT as a systems-level intervention that improves both survival and resource utilization in severe PE. Prospective multicenter studies are now warranted to confirm causality and define which PE phenotypes derive the greatest benefit from formal PERT activation. This abstract is funded by: None