LIANG Ying 1 , WANG Xiao 2 , MIAO Huangtai 2 , ZUO Huijuan 3 , NIE Shaoping 2
  • 1. Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;
  • 2. Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;
  • 3. Department of Clinical and Community CVD Prevention, Beijing Institute of Heart and Blood Vessel Disease, Beijing 100029, P. R. China;
NIE Shaoping, Email: spnie@ccmu.edu.cn
Acute pulmonary embolism; multidisciplinary; Pulmonary Embolism Response Team; treatment strategies; long-term prognosis
10.7507/1671-6205.202309039
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Objectives To evaluate the effects of Pulmonary Embolism Response Team (PERT) on treatment strategies and long-term prognosis in patients with acute pulmonary embolism before and after the implementation of the first PERT in China. Methods  The official start of PERT (July 2017) was took as the cut-off point, all APE patients who attended Beijing Anzhen Hospital of Capital Medical University one year before and after this cut-off time were included through the hospital electronic medical record system. The APE patients who received traditional treatment from July 5, 2016 to July 4, 2017 were recruited in the control group (Pre-PERT group), and the APE patients who received PERT mode treatment from July 5, 2017 to July 4, 2018 were recruited as the intervention group (Post-PERT group). Treatment methods during hospitalization were compared between the two groups. The patients were followed up for one year after discharge to evaluate their anticoagulant therapy, follow-up compliance and long-term prognosis. Results  A total of 108 cases in the Pre-PERT group and 102 cases in the Post-PERT group were included. There was no significant statistical difference between the two groups in age and gender (both P>0.05). Anticoagulation therapy (87.3% vs. 81.5%, P=0.251), catheter-directed treatment (3.9% vs. 2.8%, P=0.644), inferior vena cava filters (1.0% vs. 1.9%, P=1.000), surgical embolectomy (2.0% vs. 0.9%, P=0.613), systemic thrombolysis (3.9% vs. 4.6%, P=0.582) were performed in both groups with no significant differences between the two groups. The use rate of rivaroxaban in the Post-PERT group was higher than that in the Pre-PERT group at one year of discharge, and the use rate of warfarin was lower than that of the Pre-PERT group (54.5% vs. 32.5%; 43.6% vs. 59.0%, P=0.043). The anticoagulation time of the Post-PERT group was longer than that of the Pre-PERT group (11.9 months vs. 10.3 months, P<0.001). The all-cause mortality within one year, hemorrhagic events and the rate of rehospitalization due to pulmonary embolism were not significantly different between the two groups, (10.4% vs. 8.6%), (14.3% vs. 14.8%), and (1.3% vs. 2.5%, χ2=3.453, P=0.485), respectively. Conclusions  APE treatment was still dominated by anticoagulation and conventional treatment at the early stage of PERT implementation, and advanced treatment (catheter-directed treatment and surgical embolectomy) is improved, it showed an expanding trend after only one year of implementation although there was no statistical difference. At follow-up, there is no increase in one-year all-cause mortality and bleeding events with a slight increase in advanced treatment after PERT implementation.

Citation： LIANG Ying, WANG Xiao, MIAO Huangtai, ZUO Huijuan, NIE Shaoping. Effects of Pulmonary Embolism Response Team (PERT) on treatment strategies and long-term prognosis in patients with acute pulmonary embolism. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(11): 782-788. doi: 10.7507/1671-6205.202309039 Copy

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