Changes in Care for Acute Pulmonary Embolism with a Multidisciplinary Pulmonary Embolism Response Team: PE Response Team.

Abstract Background Optimal management of acute pulmonary embolism requires expertise offered by multiple subspecialties. As such, pulmonary embolism response teams (PERT) have increased in prevalence, but the institutional consequences of a PERT are unclear. Methods We compared all patients that presented to our institution with an acute pulmonary embolism in the three years prior to and three years after the formation of our PERT. The primary outcome was in-hospital pulmonary embolism-related mortality before and after formation of PERT. Sub-analyses were performed among patients with elevated-risk pulmonary embolism. Results Between August 2012 and August 2018, 2,042 patients were hospitalized with an acute pulmonary embolism, 884 (41.3%) in the pre-PERT era and 1,158 (56.7%) in the PERT era, of which 165 (14.2%) were evaluated by PERT. There was no difference in PE-related mortality between eras (2.6% pre-PERT vs 2.9% PERT era, p = 0.89). There was increased risk stratification assessment by measurement of cardiac biomarkers and echocardiograms in the PERT-era. Overall utilization of advanced therapy was similar between groups (5.4% pre-PERT vs 5.4% PERT, p = 1.0), with decreased use of systemic thrombolysis (3.8% pre-PERT vs 2.1% PERT, p = 0.02) and increased catheter-directed therapy (1.3% pre-PERT vs 3.3% PERT, p = 0.05) in the PERT era (Figure 1a). Inferior vena cava filter use decreased in the PERT era (10.7% pre-PERT vs 6.9% PERT, p = 0.002). Findings were similar when analyzing elevated-risk patients. Conclusion PERTs may increase risk stratification assessment, alter application of advanced therapies, but a mortality benefit was not identified.