Effect of a Multidisciplinary Pulmonary Embolism Response Team on Patient Mortality
| Autor: | Igor Gosev, Scott J. Cameron, Yu Lin Chen, Nicole M. Acquisto, Justin Mazzillo, Scott McNitt, Mark Marinescu, Colin Wright, Ilan Goldenberg, Joseph Van Galen, Joseph M. Delehanty, Annelise Hamer, Ayman Elbadawi, Anthony P. Pietropaoli, Susan Schleede, Bryan Barrus |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Relative risk reduction medicine.medical_specialty Multivariate analysis Article Internal medicine medicine Risk of mortality Humans Thrombolytic Therapy Hospital Mortality Patient Care Team Academic Medical Centers business.industry Mortality rate Hazard ratio Emergency department Middle Aged medicine.disease Triage United States Pulmonary embolism Survival Rate Emergency medicine Cardiology Female Emergency Service Hospital Pulmonary Embolism Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Am J Cardiol |
| ISSN: | 0002-9149 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect