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A Multidisciplinary Pulmonary Embolism Response Team: Initial 30-Month Experience With a Novel Approach to Delivery of Care to Patients With Submassive and Massive Pulmonary Embolism.

Authors :
Kabrhel, Christopher
Rosovsky, Rachel
Channick, Richard
Jaff, Michael R.
Weinberg, Ido
Sundt, Thoralf
Dudzinski, David M.
Rodriguez-Lopez, Josanna
Parry, Blair A.
Harshbarger, Savanah
Yuchiao Chang
Rosenfield, Kenneth
Chang, Yuchiao
Source :
CHEST. Aug2016, Vol. 150 Issue 2, p384-393. 10p.
Publication Year :
2016

Abstract

<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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%.<bold>Conclusions: </bold>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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00123692
Volume :
150
Issue :
2
Database :
Academic Search Index
Journal :
CHEST
Publication Type :
Academic Journal
Accession number :
117161199
Full Text :
https://doi.org/10.1016/j.chest.2016.03.011