Key result
Management by a Pulmonary Embolism Response Team did not significantly reduce short-term mortality compared to conventional treatment (P=0.642), but significantly reduced hospital length-of-stay.
Why the study?
The study was conducted to evaluate the effectiveness of the Pulmonary Embolism Response Team (PERT) for intermediate-high risk and high-risk pulmonary embolism patients.
Does management by a Pulmonary Embolism Response Team (PERT) reduce short-term mortality and improve clinical outcomes in patients with intermediate-high risk and high-risk pulmonary embolism?
RCT (n=74)
Single-blind
Does management by a Pulmonary Embolism Response Team (PERT) reduce short-term mortality and improve clinical outcomes in patients with intermediate-high risk and high-risk pulmonary embolism?
Answers are grounded in this paper and cite their sources.
Management of intermediate-high and high-risk pulmonary embolism by a PERT team significantly reduces time to decision and hospital length-of-stay, and improves right ventricular indices, despite no significant difference in short-term mortality.
BACKGROUND: We aimed to evaluate the effectiveness of the Pulmonary Embolism Response Team (PERT) for intermediate-high risk and high-risk pulmonary embolism (PE) patients. METHODS: This single-blind clinical trial was performed in 2019-2021, evaluating patients with intermediate-high risk and high risk of PE. Patients in the intervention group were managed by the PERT team, and treatment plans were implemented as soon as possible. Patients in the other group received conventional PE treatments based on the hospital protocols. We compared the primary outcome of short-term mortality between the 2 groups and secondary outcomes, including right ventricle indices, hospital length-of-stay, time to decision, 30-day and in-hospital bleeding. RESULTS: Data of 74 patients were analyzed. We found no significant differences between the 2 groups regarding short-term mortality (P = 0.642), bleeding, and other complications. However, the length-of-stay and time to decision were significantly lower in patients treated by the PERT team (P < 0.001 for both). Further evaluations revealed that patients in the intervention group had a more significant reduction in the right ventricle size and systolic pulmonary pressure compared with the control group (P = 0.015, P = 0.039, respectively). In addition, tricuspid annular plane systolic excursion and fractional area change increased more in the intervention group (P = 0.023, P = 0.016, respectively). CONCLUSIONS: The PERT team led to significantly less time to make decisions, and it was able to select patients for advanced treatments more appropriately. Due to these facts, patients treated by PERT had significantly lower hospitalization duration and better right ventricle indices compared to controls.
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Mansouri et al. (2022) conducted an RCT in Intermediate-high risk and high-risk pulmonary embolism (n=74). Pulmonary Embolism Response Team (PERT) vs. Conventional PE treatments based on hospital protocols was evaluated on Short-term mortality (p=0.642). Management by a Pulmonary Embolism Response Team did not significantly reduce short-term mortality compared to conventional treatment (P=0.642), but significantly reduced hospital length-of-stay.
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