Introduction
Pulmonary embolism (PE) continues to pose a significant challenge in clinical practice. Selecting the optimal management approach is complicated by conflicting societal guidelines, which can hinder the care team's ability to deliver effective therapies in timely fashion. To address this complexity, the Pulmonary Embolism Response Team (PERT) was introduced in 2012. This study evaluates the effectiveness of PERT and explores its integration as a standard of care for PE management.
Methods
A systematic search of databases was conducted from inception to April 2024. Relevant references were identified and imported for analysis. Statistical evaluation was performed using RevMan Web, using odds ratios (OR) for dichotomous outcomes and mean differences (MD) for continuous outcomes.
Results
The analysis included 23 studies, comprising 15,621 patients in two groups: patient managed by PERT, n=5,555 and patient managed with standard treatment without PERT, n=10,066. The use of PERT significantly lowered odds of 30-day or in-hospital mortality (OR 0.76, CI 0.59-0.99) but significantly increased the utilization of advanced therapeutic strategies (OR 3.45, CI 1.95-6.09). Although PERT demonstrated favorable odds for reduced major bleeding events and earlier achievement of therapeutic anticoagulation but could not achive statistcal significance. Also, while PERT was associated with higher odds of ICU admission (OR 2.41, CI 1.33-4.34)but significantly reduced the length of ICU stay (MD -0.67, CI -1.28 to -0.05).
Conclusion
PERT implementation has been associated with reduced mortality, shorter ICU stays, at cost of higher utilization of advanced therapies. However, given that most studies are observational, these findings should be interpreted cautiously, and higher-quality research is needed to establish definitive benefit.
扫码关注我们
求助内容:
应助结果提醒方式:
