Details

Autor(en) / Beteiligte

• Kabrhel, Christopher, MD, MPH
• Rosovsky, Rachel, MD, MPH
• Channick, Richard, MD
• Jaff, Michael R., DO
• Weinberg, Ido, MD
• Sundt, Thoralf, MD
• Dudzinski, David M., MD, JD
• Rodriguez-Lopez, Josanna, MD
• Parry, Blair A., CCRC, BA
• Harshbarger, Savanah, BS
• Chang, Yuchiao, PhD
• Rosenfield, Kenneth, MD

Titel

A Multidisciplinary Pulmonary Embolism Response Team

Ist Teil von

• Chest, 2016-08, Vol.150 (2), p.384-393

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Background Integrating newly developed tests and treatments for severe pulmonary embolism (PE) into clinical care requires coordinated multispecialty collaboration. To meet this need, we developed a new paradigm: a multidisciplinary Pulmonary Embolism Response Team (PERT). In this report, we provide the first longitudinal analysis of patients treated by a PERT. Methods Our PERT includes specialists in cardiovascular medicine and surgery, emergency medicine, hematology, pulmonary/critical care, and radiology, and is organized as a rapid response team. We prospectively captured clinical, therapeutic, and outcome data at PERT activation and during follow-up periods up to 365 days. We analyzed data collectively, and as five mutually exclusive 6-month periods. We performed Fisher exact tests and regression analysis to test for trend. Results In 30 months, there were 394 unique PERT activations, 314 (80%) for confirmed PE. PERT activations increased by 16% every 6 months. Most confirmed PEs were submassive (n = 143, 46%) or massive (n = 80, 26%). The PERT treated a relatively large proportion of patients with PE and systemic or catheter-directed thrombolysis (n = 35, 11%), though the most common treatment was anticoagulation alone (n = 215, 69%). Hemorrhagic complications were rare overall, especially among patients treated with catheter-directed thrombolysis. The all-cause 30-day mortality of PERT patients with confirmed PE was 12%. Conclusions We report our initial 30-month experience with a novel multidisciplinary PERT that rapidly engages multiple specialists to deliver efficient, organized, and evidence-based care to patients with high-risk PE. The PERT paradigm was rapidly adopted and may become a new standard of care for patients with PE.