TY - JOUR
T1 - A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium
AU - National PERT Consortium Research Committee
AU - Schultz, Jacob
AU - Giordano, Nicholas
AU - Zheng, Hui
AU - Parry, Blair A.
AU - Barnes, Geoffrey D.
AU - Heresi, Gustavo A.
AU - Jaber, Wissam
AU - Wood, Todd
AU - Todoran, Thomas
AU - Courtney, D. Mark
AU - Naydenov, Soophia
AU - Khandhar, Sameer
AU - Green, Philip
AU - Kabrhel, Christopher
N1 - Funding Information:
The authors extent our acknowledgments to all members of the National PERT Consortium™ who have contributed with their hard work in the establishment of the National PERT Consortium™ multicenter registry. We especially thank all the people involved in entering data for their efforts. Data collection and analysis was approved by the Human Research Committee of Partners HealthCare (protocol number 2012P002257) as well as contributing sites.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background: We provide the first multicenter analysis of patients cared for by eight Pulmonary Embolism Response Teams (PERTs) in the United States (US); describing the frequency of team activation, patient characteristics, pulmonary embolism (PE) severity, treatments delivered, and outcomes. Methods: We enrolled patients from the National PERT Consortium™ multicenter registry with a PERT activation between 18 October 2016 and 17 October 2017. Data are presented combined and by PERT institution. Differences between institutions were analyzed using chi-squared test or Fisher's exact test for categorical variables, and ANOVA or Kruskal-Wallis test for continuous variables, with a two-sided P value < 0.05 considered statistically significant. Results: There were 475 unique PERT activations across the Consortium, with acute PE confirmed in 416 (88%). The number of activations at each institution ranged from 3 to 13 activations/month/1000 beds with the majority originating from the emergency department (281/475; 59.3%). The largest percentage of patients were at intermediate–low (141/416, 34%) and intermediate–high (146/416, 35%) risk of early mortality, while fewer were at high-risk (51/416, 12%) and low-risk (78/416, 19%). The distribution of risk groups varied significantly between institutions (P = 0.002). Anticoagulation alone was the most common therapy, delivered to 289/416 (70%) patients with confirmed PE. The proportion of patients receiving any advanced therapy varied between institutions (P = 0.0003), ranging from 16% to 46%. The 30-day mortality was 16% (53/338), ranging from 9% to 44%. Conclusions: The frequency of team activation, PE severity, treatments delivered, and 30-day mortality varies between US PERTs. Further research should investigate the sources of this variability.
AB - Background: We provide the first multicenter analysis of patients cared for by eight Pulmonary Embolism Response Teams (PERTs) in the United States (US); describing the frequency of team activation, patient characteristics, pulmonary embolism (PE) severity, treatments delivered, and outcomes. Methods: We enrolled patients from the National PERT Consortium™ multicenter registry with a PERT activation between 18 October 2016 and 17 October 2017. Data are presented combined and by PERT institution. Differences between institutions were analyzed using chi-squared test or Fisher's exact test for categorical variables, and ANOVA or Kruskal-Wallis test for continuous variables, with a two-sided P value < 0.05 considered statistically significant. Results: There were 475 unique PERT activations across the Consortium, with acute PE confirmed in 416 (88%). The number of activations at each institution ranged from 3 to 13 activations/month/1000 beds with the majority originating from the emergency department (281/475; 59.3%). The largest percentage of patients were at intermediate–low (141/416, 34%) and intermediate–high (146/416, 35%) risk of early mortality, while fewer were at high-risk (51/416, 12%) and low-risk (78/416, 19%). The distribution of risk groups varied significantly between institutions (P = 0.002). Anticoagulation alone was the most common therapy, delivered to 289/416 (70%) patients with confirmed PE. The proportion of patients receiving any advanced therapy varied between institutions (P = 0.0003), ranging from 16% to 46%. The 30-day mortality was 16% (53/338), ranging from 9% to 44%. Conclusions: The frequency of team activation, PE severity, treatments delivered, and 30-day mortality varies between US PERTs. Further research should investigate the sources of this variability.
KW - assessing and improving clinician behavior
KW - cardiopulmonary pharmacology and therapeutics
KW - cardiovascular diseases
KW - pulmonary embolism
KW - registries
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U2 - 10.1177/2045894018824563
DO - 10.1177/2045894018824563
M3 - Article
C2 - 30632901
AN - SCOPUS:85061660350
SN - 2045-8932
VL - 9
JO - Pulmonary Circulation
JF - Pulmonary Circulation
IS - 3
ER -