TY - JOUR
T1 - Effect of a Multidisciplinary Pulmonary Embolism Response Team on Patient Mortality
AU - Wright, Colin
AU - Goldenberg, Ilan
AU - Schleede, Susan
AU - McNitt, Scott
AU - Gosev, Igor
AU - Elbadawi, Ayman
AU - Pietropaoli, Anthony
AU - Barrus, Bryan
AU - Chen, Yu Lin
AU - Mazzillo, Justin
AU - Acquisto, Nicole M.
AU - Van Galen, Joseph
AU - Hamer, Annelise
AU - Marinescu, Mark
AU - Delehanty, Joseph
AU - Cameron, Scott J.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/12/15
Y1 - 2021/12/15
N2 - Multidisciplinary Pulmonary Embolism Response Teams (PERTs) may improve the care of patients with a high risk of pulmonary embolism (PE). The impact of a PERT on long-term mortality has never been evaluated. An observational analysis was conducted of 137 patients before PERT implementation (between 2014 and 2015) and 231 patients after PERT implementation (between 2016 and 2019), presenting to the emergency department of an academic medical center with submassive and massive PE. The primary outcome was 6-month mortality, evaluated by univariate and multivariate analyses. PERT was associated with a sustained reduction in mortality through 6 months (6-month mortality rates of 14% post-PERT vs 24% pre-PERT, unadjusted hazard ratio of 0.57, Relative Risk Reduction of 43%, p = 0.025). There was a reduced length of stay following PERT implementation (9.1 vs 6.5 days, p = 0.007). Time from triage to a diagnosis of PE was independently predictive of mortality, and the risk of mortality was reduced by 5% for each hour earlier that the diagnosis was made. In conclusion, this study is the first to demonstrate an association between PERT implementation and a sustained reduction in 6-month mortality for patients with high-risk PE.
AB - Multidisciplinary Pulmonary Embolism Response Teams (PERTs) may improve the care of patients with a high risk of pulmonary embolism (PE). The impact of a PERT on long-term mortality has never been evaluated. An observational analysis was conducted of 137 patients before PERT implementation (between 2014 and 2015) and 231 patients after PERT implementation (between 2016 and 2019), presenting to the emergency department of an academic medical center with submassive and massive PE. The primary outcome was 6-month mortality, evaluated by univariate and multivariate analyses. PERT was associated with a sustained reduction in mortality through 6 months (6-month mortality rates of 14% post-PERT vs 24% pre-PERT, unadjusted hazard ratio of 0.57, Relative Risk Reduction of 43%, p = 0.025). There was a reduced length of stay following PERT implementation (9.1 vs 6.5 days, p = 0.007). Time from triage to a diagnosis of PE was independently predictive of mortality, and the risk of mortality was reduced by 5% for each hour earlier that the diagnosis was made. In conclusion, this study is the first to demonstrate an association between PERT implementation and a sustained reduction in 6-month mortality for patients with high-risk PE.
UR - https://www.scopus.com/pages/publications/85118832665
UR - https://www.scopus.com/pages/publications/85118832665#tab=citedBy
U2 - 10.1016/j.amjcard.2021.08.066
DO - 10.1016/j.amjcard.2021.08.066
M3 - Article
C2 - 34794606
AN - SCOPUS:85118832665
SN - 0002-9149
VL - 161
SP - 102
EP - 107
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -