A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

National PERT Consortium Research Committee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalPulmonary Circulation
Volume9
Issue number3
DOIs
StatePublished - Jul 1 2019

Fingerprint

Pulmonary Embolism
Mortality
Registries
Hospital Emergency Service
Analysis of Variance
Therapeutics

Keywords

  • assessing and improving clinician behavior
  • cardiopulmonary pharmacology and therapeutics
  • cardiovascular diseases
  • pulmonary embolism
  • registries

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{9226a1e881a74bb590a47458e4256303,
title = "A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium",
abstract = "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.",
keywords = "assessing and improving clinician behavior, cardiopulmonary pharmacology and therapeutics, cardiovascular diseases, pulmonary embolism, registries",
author = "{National PERT Consortium Research Committee} and Jacob Schultz and Nicholas Giordano and Hui Zheng and Parry, {Blair A.} and Barnes, {Geoffrey D.} and Heresi, {Gustavo A.} and Wissam Jaber and Todd Wood and Thomas Todoran and Courtney, {D. Mark} and Soophia Naydenov and Sameer Khandhar and Philip Green and Christopher Kabrhel",
year = "2019",
month = "7",
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language = "English (US)",
volume = "9",
journal = "Pulmonary Circulation",
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A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium. / National PERT Consortium Research Committee.

In: Pulmonary Circulation, Vol. 9, No. 3, 01.07.2019.

Research output: Contribution to journalArticle

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

PY - 2019/7/1

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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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