Impact of a pulmonary embolism response team (PERT) in the prognosis of patients with acute symptomatic pulmonary embolism

S. González , M. Najarro , W. Briceño , C. Rodríguez , D. Barrios , R. Morillo , A. Olavarría , A. Lietor , V. Gómez del Olmo , Á. Osorio , Á. Sánchez-Recalde , Alfonso Muriel , D. Jiménez
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Abstract

Background

The effect of a pulmonary embolism response team (PERT) in the short-term prognosis of patients with acute symptomatic pulmonary embolism (PE) lacks clarity. We therefore aimed at evaluating the effect of a PERT team on short-term mortality among patients with acute PE.

Methods

We retrospectively reviewed consecutive patients with acute symptomatic PE enrolled in a single-center registry between 2007 and 2022. We used propensity score matching to compare treatment effects for patients with similar predicted probabilities of receiving management by the PERT team. The primary outcome was all-cause mortality within 30 days following the diagnosis of PE. The secondary outcome was 30-day PE-related mortality.

Results

Of the 2,902 eligible patients who had acute symptomatic PE, 223 (7.7%; 95% confidence interval [CI], 6.7%–8.7%) were managed by the PERT team. Two hundred and seven patients who were treated by the PERT were matched with 207 patients who were not. Matched pairs did not show a statistically significant lower all-cause (odds ratio [OR], 1.09; 95% CI, 0.63–1.89) or PE-related death (OR, 1.30; 95% CI, 0.47–3.62) for PERT management compared with no PERT management through 30 days after diagnosis of PE.

Conclusions

Our results suggest that multidisciplinary care of patients with acute symptomatic PE by a PERT team is not associated with a significant reduction in short-term all-cause or PE-related mortality.

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肺栓塞应对小组对急性无症状肺栓塞患者预后的影响。
背景:肺栓塞应对小组(PERT)对急性无症状肺栓塞(PE)患者短期预后的影响尚不明确。因此,我们旨在评估肺栓塞应对小组对急性肺栓塞患者短期死亡率的影响:我们回顾性分析了 2007 年至 2022 年间在单中心登记处登记的急性无症状 PE 连续患者。我们使用倾向评分匹配法比较了接受 PERT 团队治疗的预测概率相似的患者的治疗效果。主要结果是确诊 PE 后 30 天内的全因死亡率。次要结果是 30 天内 PE 相关死亡率:在 2902 名符合条件的急性无症状 PE 患者中,有 223 人(7.7%;95% 置信区间 [CI],6.7%-8.7%)接受了 PERT 小组的治疗。接受 PERT 治疗的 277 名患者与未接受 PERT 治疗的 207 名患者进行了配对。与确诊 PE 后 30 天内未接受 PERT 治疗的患者相比,接受 PERT 治疗的患者的全因死亡(几率比 [OR],1.09;95% CI,0.63-1.89)或 PE 相关死亡(OR,1.30;95% CI,0.47-3.62)均无统计学意义:我们的研究结果表明,由PERT团队对急性无症状PE患者进行多学科治疗并不能显著降低短期全因或PE相关死亡率。
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