Effect of a Multidisciplinary Pulmonary Embolism Response Team on Patient Mortality.

Autor: Wright C; Division of Cardiology., Goldenberg I; Division of Cardiology; Cardiovascular Research Center., Schleede S; Division of Cardiology; Cardiovascular Research Center., McNitt S; Division of Cardiology; Cardiovascular Research Center., Gosev I; Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York., Elbadawi A; Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas., Pietropaoli A; Division of Pulmonary Medicine, Department of Medicine, University of Rochester Medical Center, Rochester, New York., Barrus B; Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York., Chen YL; Division of Cardiology., Mazzillo J; Department of Emergency Medicine., Acquisto NM; Department of Emergency Medicine; Department of Pharmacy, University of Rochester Medical Center, Rochester, New York., Van Galen J; Division of Cardiology., Hamer A; Division of Cardiology., Marinescu M; Division of Cardiology; Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York., Delehanty J; Division of Cardiology; Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York., Cameron SJ; Division of Cardiology; Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York; Section of Vascular Medicine, Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Case Western Reserve University Lerner College of Medicine, Cleveland, Ohio; Department of Hematology, Taussig Cancer Center, Cleveland, Ohio. Electronic address: cameros3@ccf.org.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2021 Dec 15; Vol. 161, pp. 102-107.
DOI: 10.1016/j.amjcard.2021.08.066
Abstrakt: 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.
Competing Interests: Disclosures The authors have no conflicts of interest to declare.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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