%0 Journal Article
%T A pulmonary embolism response team¡¯s initial 20 month experience treating 87 patients with submassive and massive pulmonary embolism
%A Akhilesh K Sista
%A Arash Salemi
%A Brendan Denvir
%A Eda Dou
%A Gulce Askin
%A Jaclyn Estes
%A James M Horowitz
%A Jamie Stern
%A Oren A Friedman
%A Ronald S Winokur
%J Vascular Medicine
%@ 1477-0377
%D 2018
%R 10.1177/1358863X17730430
%X Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded. A total of 124 PERT activations occurred over 20 months: 43 in the first 10 months and 81 in the next 10. A total of 87 submassive (90.8%) and massive (9.2%) PE patients were included. The median age was 65 (51¨C75 IQR) years. Catheter-directed thrombolysis (CDT) was administered to 25 patients, systemic thrombolysis (ST) to six, and anticoagulation alone (AC) to 54. The median ICU stay and overall LOS were 6 (3¨C10 IQR) and 7 (4¨C14 IQR) days, respectively, with no association with any variables except a brain natriuretic peptide (BNP) >100 pg/mL (p=0.008 ICU LOS; p=0.047 overall LOS). Twelve patients (13.7%) died in the hospital, nine of whom had metastatic or brain cancer, with a median overall LOS of 13 (11¨C17 IQR) days. There were five major bleeds: one in the CDT group, one in the ST group, and three in the AC group. Overall, (1) PERT activations increased after the first 10 months; (2) BNP >100 pg/mL was associated with a longer LOS; (3) rates of mortality and bleeding did not correlate with treatment; and (4) the majority of in-hospital deaths occurred in patients with advanced cancer
%K pulmonary embolism (PE)
%K PE response team (PERT)
%K massive PE
%K submassive PE
%K catheter-directed thrombolysis
%K hospital length of stay
%U https://journals.sagepub.com/doi/full/10.1177/1358863X17730430