| Autor: |
Carroll, Brett, Mehegan, Tyler, Weinstein, Jeffrey J, Bauer, Kenneth, Hayes, Margaret, Chu, Louis M, Locke, Andrew, Godishala, Anuradha, Dicks, Andrew, Soriano, Kevin, Kanduri, Jaya, Sack, Kelsey, Marcus, Mason, Wiest, Cara, Pribish, Abby, Secemsky, Eric A, Pinto, Duane S |
| Zdroj: |
Circulation (Ovid); November 2019, Vol. 140 Issue: Supplement 1 pA15600-A15600, 1p |
| Abstrakt: |
Introduction:There has been a rapid increase in the development pulmonary embolism response teams (PERT). Advocates suggest PERTs are the new standard of care for patients with complex PE; however, little data exist comparing outcomes before and after creation of a PERT.Hypothesis:A PERT will reduce mortality for patients with complex PE.Methods:This was a retrospective analysis of all patients with acute PE at an academic, tertiary care medical center for the 3 years prior to the development of a PERT (August 2012 through July 2015) and 3 years after establishment of a PERT (August 2015 through July 2018). We evaluated differences in outcomes (mortality and readmission) and practice patterns between groups. The primary outcome was PE-related mortality in patients cared for in an intensive care unit with intermediate or high-risk PE.Results:In the pre-PERT era, 890 patients were hospitalized with acute PE, of which 194 (22%) patients were cared for in an ICU with an intermediate or high-risk PE compared to 272 of 1163 (23%) in the PERT era. PERT consultation was performed in 164 patients in the PERT era (14%), including 115 of the 272 patients admitted to an ICU with elevated-risk PE. Demographics and comorbidities did not differ significantly eras. Utilization of advanced therapies were similar between eras, yet catheter-directed therapy accounted for a greater proportion in the PERT era (Figure 1). In addition, IVC filters were less frequently utilized in the PERT era. There was a non-significant trend toward a decrease in PE-related mortality in the PERT era (13.4% vs 8.8%; p=0.13). In-hospital mortality and 30-day readmissions were similar.Conclusions:Presence of a PERT was associated with similar use of advanced therapies and lower use of IVC filters among patients with elevated-risk PE. There is a suggestion that PE-related mortality decreased in the post-PERT era, but further analyses are needed to confirm this finding. |
| Databáze: |
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